title: The Value of Performing Early Non-enhanced CT in Developing Strategies for Treating Acute Gallstone Pancreatitis.
abstract: BACKGROUND
  The purpose of this study is to assess the value of early abdominal non-enhanced computed tomography (NECT) in developing strategies for treating acute gallstone pancreatitis (AGP).
  
  
  METHODS
  AGP patients underwent NECT within 48 h after symptom onset to determine the presence of peripancreatic fluid collection, gallstones, and common bile duct stones. Patients with mild AGP who had neither organ failure by clinical data nor peripancreatic fluid collection by NECT (classified as grade A, B, or C based on the Balthazar CT grading system) were randomized to undergo an early laparoscopic cholecystomy (ELC; LC performed within 7 days after a pancreatitis attack, without waiting for symptom resolution) or late laparoscopic cholecystomy (LLC; LC performed ≥ 7 days following an attack, with the patient being completely free of AGP symptoms).
  
  
  RESULTS
  The study enrolled 102 patients with mild AGP defined by clinical data and NECT. NECT was 89.2 % and 87.8 % accurate in detecting gallbladder stones and CBD stones, respectively. Totals of 49 and 53 patients were assigned to an ELC and LLC group, respectively. All patients in both groups were cured, no LC-related complications occurred, and no case of AGP increased in severity following LC. The mean lengths of hospital stay and LC operation time were significantly shorter in the ELC group than the LLC group (P < 0.05).
  
  
  CONCLUSIONS
  NECT can accurately detect peripancreatic fluid collection and biliary obstructions; thus, early abdominal NECT is valuable when developing strategies for treating AGP. Patients with mild AGP without organ failure or peripancreatic fluid collection can safely undergo ELC without waiting for complete resolution of their pancreatitis.
authors.affiliation: Department of General Surgery, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Pudong New Area Gongli Hospital, Shanghai, 200135, China. linengp@163.com.
authors.forename: Neng-ping
authors.initials: NP
authors.lastname: Li
authors.affiliation: Department of Radiology, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Bing-cang
authors.initials: BC
authors.lastname: Huang
authors.affiliation: Department of Radiology, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Ya-yun
authors.initials: YY
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of General Surgery, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Jiang-nan
authors.initials: JN
authors.lastname: Dong
authors.affiliation: Department of General Surgery, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Tao-ying
authors.initials: TY
authors.lastname: Qi
authors.affiliation: Department of General Surgery, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Rong-long
authors.initials: RL
authors.lastname: Xia
authors.affiliation: Department of General Surgery, Pudong New Area Gongli Hospital, Shanghai, 200135, China.
authors.forename: Jiang-Qi
authors.initials: JQ
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000601:surgery*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Acute gallstone pancreatitis; Computed tomography; Laparoscopic cholecystectomy