OPEN IN READ APP
JOURNAL ARTICLE

Outcome of laparoscopic cholecystectomy in acute biliary pancreatitis

Hayan A Bismar, Saleh M Al-Salamah
Saudi Medical Journal 2003, 24 (6): 660-4
12847599

OBJECTIVE: To evaluate the efficacy, safety, and timing of laparoscopic cholecystectomy in the management of mild to moderate cases of acute biliary pancreatitis.

METHODS: The medical records of 158 patients admitted to Riyadh Medical Complex, Riyadh, Kingdom of Saudi Arabia (KSA) from July 1998 to December 2001 were retrospectively reviewed. Acute biliary pancreatitis was diagnosed in patients who presented with abdominal pain with serum amylase level 3 times the normal limits in the absence of hypercalcemia or hyperlipidemia and presence of gallstones on ultrasonography. Severity of the disease was assessed using Atlanta Symposium criteria. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) was performed in 106 patients (74.6%) on selective basis. One hundred and eighteen patients underwent laparoscopic cholecystectomy after clinical and biochemical resolution of the attack. Standard 4 ports technique was used. Intraoperative and postoperative morbidity and mortality, and postoperative hospital stay were reported.

RESULTS: Laparoscopic cholecystectomy was performed in 118 patients and it was possible in 110 cases (93.2%) after 3-8 days of admission. Preoperative ERCP was performed in 106 patients of mild to moderate acute biliary pancreatitis and common duct stones were retrieved in 19 cases (18%). The procedure was converted to open in 8 cases (6.7%). Postoperative complications were nausea and vomiting in 10, atelectasis in 8, chest infection in 3, and prolonged ileus in 2. The wound complication occurred in 4. One patient who had bile leak due to cystic duct stump avulsion at CBD junction was treated by endoscopic sphincterotomy plus stenting and another patient had partial CBD injury repaired primarily over a T-tube. Mean postoperative hospital stay was 2.4 days. One patient died due to uncontrolled arrhythmia and heart failure.

CONCLUSION: Laparoscopic cholecystectomy can be safely performed for mild to moderate acute biliary pancreatitis after clinical and biochemical resolution of the attack during the same admission with acceptable morbidity and mortality rates. This strategy will lead to reducing the recurring acute biliary pancreatitis, number of admissions and hospital stay.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
12847599
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"