How Does Cholecystectomy Influence Recurrence of Idiopathic Acute Pancreatitis?
Idiopathic acute pancreatitis is diagnosed in approximately 10-30 % of cases of acute pancreatitis. While there is evidence to suggest that the cause in many of these patients is microlithiasis, this fact has not been translated into a resource efficient treatment strategy that is proven to reduce recurrence rates. The aim of this study was to examine the value of prophylactic cholecystectomy following an episode of acute pancreatitis in patients with no history of alcohol abuse and no stones found on ultrasound.



This was a retrospective study of 2236 patients who presented to a regional Australian hospital. Patients were included when diagnosed with acute pancreatitis with no confirmed cause. Recurrence of acute pancreatitis was compared between those that did and did not undergo cholecystectomy.



One hundred ninety-five consecutive patients met the study definition of "idiopathic" acute pancreatitis. 33.8 % (66/195) underwent cholecystectomy. The patients who had cholecystectomy had a recurrence rate of 19.7 % (13/66) whereas, of those managed expectantly, 42.8 % (68/159) had at least one recurrence of acute pancreatitis (P = 0.001).



Following an episode of acute pancreatitis with no identifiable cause, in patients fit for surgery, cholecystectomy should be considered to reduce the risk of recurrent episodes of pancreatitis.
Department of Surgery, University Hospital Geelong, PO Box 281, Geelong, 3220, Australia. Claire.stevens@me.com.
Claire L
CL
Stevens
Department of Surgery, University Hospital Geelong, PO Box 281, Geelong, 3220, Australia.
Saleh M
SM
Abbas
Department of Surgery, University Hospital Geelong, PO Box 281, Geelong, 3220, Australia.
David A K
DA
Watters
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000517:prevention & control* / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D055502:Secondary Prevention; D057832:Watchful Waiting; D055815:Young Adult
Cholecystectomy; Pancreatitis; Recurrence
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