A study of early laparoscopic cholecystectomy in mild acute gallstone pancreatitis

Abstract

Abstract Background: Acute pancreatitis, secondary to gallstones, is a challenging situation in terms of decision regarding the timing of surgical intervention. There are studies which show no difference in terms of conversion rate, complication rate, and technical difficulty when timings of laparoscopic cholecystectomy (LC) are performed in acute biliary pancreatitis. The present study is done to evaluate the efficacy, safety, and outcome of early LC in patients of mild gallstone pancreatitis (GP) in index hospital admission. Patients and Methods: A total of 107 patients were included in the study. The patients having mild GP were classified as per Glasgow’s modification of Ranson’s criteria underwent LC in index admission, control group A, in which LC was carried out after interval of 6–8 weeks of discharge and control B group comprised patients of gallstones who do not have pancreatitis. Results: The adhesions were mostly fibrinous in the study group and fibrous in the control A group amounting to increased operating time in the control A group.A2- Increased GB thickness and GB wall edema found in patients of acute cholecystitis in study group amounted lesser chances of GB perforation and spillage of bile, better planes of dissection because of surrounding oedematous tissue and subsequently lesser operating time. No increased intraoperative complications were noted in the study group. The total duration of hospital stay was significantly reduced in the study group. Recurrent hospital admission was observed in the control A group due to other biliary events. Conclusion: LC in the index admission decreases hospital stay and prevents further attacks of pancreatitis in future. Proper selection, categorization of patients, and early operation are not associated with any increased anesthetic and surgical hazard.