Publication:

Acute mild gallstone pancreatitis: timing of cholecystectomy

Background Cholecystectomy is essential to prevent recurrent attacks of mild acute gallstone pancreatitis, but the precise timing of cholecystectomy remains a subject of ongoing debate. The aim of this study is to address the optimal timing of cholecystectomy in patients with mild acute gallstone pancreatitis.

Methods From September 2013 to September 2018, patients with mild acute gallstone pancreatitis were prospectively randomized to either an early laparoscopic cholecystectomy (ELC) versus a delayed laparoscopic cholecystectomy (DLC) group. Recurrent biliary complications, success and failure rate, difficulty of cholecystectomy, operative time, cholecystectomy related complications, length of admission between the two groups were evaluated.

Results A total of 80 patients were randomized to the ELC (41 patients) and to the DLC group (39 patients). There were a statistically significant differences in the total length of hospital stay and recurrent biliary events (4.5±1.1 vs. 7.4±2.6 days, p<0.01 and 4.9% vs. 41%, p<0.001; respectively). There were no differences regarding success and failure rate, difficulty of cholecystectomy, operative time, cholecystectomy related complications, and length of index admission between both groups.

Conclusions In mild gallstone pancreatitis, ELC results in a shorter overall hospital stay with a significant reduction in the recurrent biliary events with no apparent impact on the safety and technical difficulty of the procedure or perioperative complication rate.