November 12, 2014
Notes: Jin, Tao
Research Support, Non-U.S. Gov’t
Sichuan Da Xue Xue Bao Yi Xue Ban. 2013 Nov;44(6):970-3.
Author Address: Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
Reference Type: Journal Article
Record Number: 4694Author: Johnstone, M., Marriott, P., Royle, T. J., Richardson, C. E., Torrance, A., Hepburn, E., Bhangu, A., Patel, A., Bartlett, D. C., Pinkney, T. D., Gallstone Pancreatitis Study, Group and West Midlands Research, Collaborative
Title: The impact of timing of cholecystectomy following gallstone pancreatitis
Short Title: The impact of timing of cholecystectomy following gallstone pancreatitis
Alternate Journal: The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
ISSN: 1479-666X (Print)
Accession Number: 24210949
Abstract: INTRODUCTION: Current guidelines for the management of acute gallstone pancreatitis recommend cholecystectomy as definitive treatment during primary admission or within 2 weeks of discharge, with the aim of preventing recurrent pancreatitis. However, cholecystectomy during the inflammatory phase may increase surgical complication rates. This study aimed to determine whether adherence to the guidelines prevents recurrent pancreatitis while minimising surgical complications. METHODS: Multi-centre review of seven UK hospitals, indentifying patients presenting with their first episode of gallstone pancreatitis between 2006 and 2008. RESULTS: A total of 523 patients with gallstone pancreatitis were identified, of which 363 (69%) underwent cholecystectomy (72 during the primary admission or within 2 weeks of discharge; 291 following this). Overall, 7% of patients had a complication related to cholecystectomy of which a greater proportion occurred when cholecystectomy was performed within guideline parameters (13% vs 6%; p = 0.07). 11% of patients were readmitted with recurrent pancreatitis prior to surgery, with those undergoing cholecystectomy outside guideline parameters being most at risk (p = 0.006). CONCLUSION: This study suggests cholecystectomy within guideline parameters significantly reduces recurrence of pancreatitis but may increase the risk of surgical complications. A prospective randomised study to assess the associated morbidity is required to inform future guidelines.