Rationale of on admission surgical intervention on outcomes after cholecystectomy for mild gallstone pancreatitis

Abstract

Objectives To evaluate the association of timing for cholecystectomy with clinical outcomes in patients with gallstone pancreatitis (GSP). Background Patients with mild GSP who undergo cholecystectomy sooner rather than later tend to have shorter hospital stays. Patients and methods From October 2019 to January 2023, the number of adult hospitalizations at Menoufia University Hospitals due to GSP was recorded. We classified patients into early (operated on within 2 days of admission) as well as late (operated on over 2 days after admission) groups based on when they had laparoscopic cholecystectomy. The date of cholecystectomy was then correlated with nonhome discharge, postoperative hospital length of stay, and readmission rate within a month of discharge using multivariable logistic and linear regression. Results An estimated 129 patients were admitted with acute GSP, and 25.6% of those admissions were classified as belonging to the early cohort. The remaining admissions were classified as belonging to the late cohort. After taking into account potential confounding factors, a late cholecystectomy was found to be linked with a greater risk of significant adverse outcomes [adjusted odds ratio 1.40, 95% confidence interval (CI): 1.24–1.51]. Also, participants in the late cohort had a greater chance of being readmitted within 30 days (adjusted odds ratio 1.12, 95% CI: 1.03–1.23) and nonhome discharge (adjusted odds ratio 1.41, 95% CI: 1.29–1.53). Conclusion Cholecystectomy that was performed after 2 days of admission for mild GSP was associated with increased major adverse events and 30-day readmissions, in addition to nonhome discharge.