Timing of cholecystectomy in biliary pancreatitis treatment.
OBJECTIVE
Gallstone pancreatitis constitutes 40% of all cases with pancreatitis while it constitutes up to 90% of cases with acute pancreatitis. The treatment modality in this patient population is still controversial. In this study, we aimed to compare the results of early and late cholecystectomy for patients with biliary pancreatitis.


METHODS
Patients treated with a diagnosis of acute biliary pancreatitis in our clinics between January 2000 and December 2011 were retrospectively reviewed. Patients were divided into two groups: Group A, patients who underwent cholecystectomy during the first pancreatitis attack, Group B, patients who underwent an interval cholecystectomy at least 8 weeks after the first pancreatitis episode. The demographic characteristics, clinical symptoms, number of episodes, length of hospital stay, morbidity and mortality data were recorded. All data were evaluated with Statistical Package for the Social Sciences (SPSS) 13.0 for windows and p <0.05 was considered as statistically significant.


RESULTS
During the last 12 years, a total of 91 patients with surgical treatment for acute biliary pancreatitis were included into the study. There were 62 female and 29 male patients, with a mean age of 57.9±14.6 years (range: 21-89). A concomitant acute cholecystitis was present in 46.2% of the patients. Group A and B included 48 and 43 patients, respectively. The length of hospital stay was significantly higher in group B (9.4 vs. 6.8 days) (p<0,05). More than half of the patients in Group B were readmitted to the hospital for various reasons. No significant difference was observed between the two groups, one patient died due to heart failure in the postoperative period in group B.


CONCLUSIONS
In-hospital cholecystectomy after remission of acute pancreatitis is feasible. It will not only result in lower recurrence and complication rates but also shorten length of hospital stay. We recommend performing cholecystectomy during the course of the first episode in patients with acute pancreatitis.
Clinic of General Surgery, Şişli Hamidiye Etfal Training Hospital, İstanbul, Turkey.
Uygar
U
Demir
Clinic of General Surgery, Şişli Hamidiye Etfal Training Hospital, İstanbul, Turkey.
Pınar
P
Yazıcı
Clinic of General Surgery, Şişli Hamidiye Etfal Training Hospital, İstanbul, Turkey.
Özgür
Ö
Bostancı
Clinic of General Surgery, Şişli Hamidiye Etfal Training Hospital, İstanbul, Turkey.
Cemal
C
Kaya
Clinic of General Surgery, Şişli Hamidiye Etfal Training Hospital, İstanbul, Turkey.
Hakan
H
Köksal
Clinic of General Surgery, Şişli Hamidiye Etfal Training Hospital, İstanbul, Turkey.
Gürhan
G
Işıl
Clinic of General Surgery, Şişli Hamidiye Etfal Training Hospital, İstanbul, Turkey.
Emre
E
Bozdağ
Clinic of General Surgery, Şişli Hamidiye Etfal Training Hospital, İstanbul, Turkey.
Mehmet
M
Mihmanlı
Biliary pancreatitis; cholecystectomy; surgical treatment