title: Can the timing of laparoscopic cholecystectomy after biliary pancreatitis change the conversion rate to open surgery?
abstract: BACKGROUND
  Biliary pancreatitis (BP) constitutes 30-55% of all cases of acute pancreatitis. Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease. We aimed to compare and evaluate the relation between the timing of LC and the rates and reasons of conversion to open surgery (OS) after BP.
  
  
  METHODS
  Data were collected of patients who presented for the first time with acute BP and underwent LC. The patients were divided into two groups: early cholecystectomy (Group 1), patients who underwent cholecystectomy during the first pancreatitis attack upon admission and before discharge from hospital (1-3 days); and late cholecystectomy (Group 2), patients who received medical treatment during their first pancreatitis episode and underwent surgery after 4-10 weeks. Sex, Ranson scores, American Society of Anesthesiology scores, and conversion reasons were compared.
  
  
  RESULTS
  Group 1 and Group 2 included 75 patients (20 men, 55 women) and 87 patients (25 men, 62 women), respectively. The mean age was 44.7 years (range, 21-82 years). Obscure anatomy with adhesions was detected in 16 patients (5 in Group 1, 11 in Group 2) as the leading cause of conversion to OS, but it was not statistically significant (p=0.054). Acute inflammation with empyema and peripancreatic liquid collection was observed in 14 patients (12 in Group 1, 2 in Group 2), and conversion to OS was statistically significantly higher in Group 1 (p=0.016).
  
  
  CONCLUSIONS
  Timing of LC does not influence the conversion rates to OS after BP.
authors.affiliation: General Surgery Department, Istanbul Oncology Hospital, Istanbul, Turkey.
authors.forename: Fikret
authors.initials: F
authors.lastname: Aksoy
authors.affiliation: General Surgery Department, Recep Tayyip Erdogan University Educational and Research Hospital, Rize, Turkey. Electronic address: drgokhandemiral@yahoo.com.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Demiral
authors.affiliation: General Surgery Department, Goztepe Education and Research Hospital, Medeniyet University, Istanbul, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Ekinci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D012189:Retrospective Studies; D013997:Time Factors
keywords: conversion to open surgery; laparoscopic cholecystectomy; pancreatitis