title: Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources.
abstract: BACKGROUND
  Acute pancreatitis is often a relapsing condition, particularly when its triggering factor persists. Our goal is to determine the recurrence rate of acute biliary pancreatitis after an initial episode, and the time to relapse, as well as to identify the risk factors for recurrence.
  
  
  METHODS
  We included all patients admitted for a first acute gallstone pancreatitis event during four years. Primary endpoints included readmission for recurrence and time to relapse.
  
  
  RESULTS
  We included 296 patients admitted on a total of 386 occasions. The incidence of acute biliary pancreatitis in our setting is 17.5/100,000 population/year. In all, 19.6% of pancreatitis were severe (22.6% of severe acute pancreatitis for first episodes versus 3.6% for recurring pancreatitis), with an overall mortality of 4.4%. Overall recurrence rate was 15.5%, with a median time to relapse of 82 days. In total, 14.2% of patients relapsed after an acute pancreatitis event without cholecystectomy or endoscopic retrograde cholangio-pancreatography. Severe acute pancreatitis recur in 7.2% of patients, whereas mild cases do so in 16.3%, this being the only risk factor for recurrence thus far identified.
  
  
  CONCLUSIONS
  Patients admitted for pancreatitis should undergo cholecystectomy as soon as possible or be guaranteed priority on the waiting list. Otherwise, endoscopic retrograde cholangio-pancreatography with sphincterotomy may be an alternative to surgery for selected patients.
authors: Unidad Cirugía HBP/Cirugía General , Parc Taulí Sabadell. Hospital Universitari, España.
authors: Natalia
authors: N
authors: Bejarano González
authors: Cirugía HBP / Cirugía General, Parc Taulí Sabadell. Hospital Universitari, España.
authors: Andreu
authors: A
authors: Romaguera Monzonís
authors: Unidad Cirugía HBP / Cirugía General, Parc Taulí Sabadell. Hospital Universitari, España.
authors: Francisco Javier
authors: FJ
authors: García Borobia
authors: Cirugía HBP / Cirugía General, Parc Taulí Sabadell. Hospital Universitari, España.
authors: Neus
authors: N
authors: García Monforte
authors: Unidad Cirugía HBP. Cirugía General, Parc Taulí Sabadell. Hospital Universitari, España.
authors: Sheila
authors: S
authors: Serra Plà
authors: Cirugía General, Parc Taulí Sabadell. Hospital Universitari, España.
authors: Pere
authors: P
authors: Rebasa Cladera
authors: Cirugía General, Parc Taulí Sabadell. Hospital Universitari, España.
authors: Roser
authors: R
authors: Flores Clotet
authors: Cirugía General, Parc Taulí Sabadell. Hospital Universitari, España.
authors: Salvador
authors: S
authors: Navarro Soto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006295:Health Resources; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D061665:Time-to-Treatment; D014850:Waiting Lists; D055815:Young Adult