Timing of Laparoscopic Cholecystectomy in Patients With Non-Severe Biliary Pancreatitis

Abstract

Introduction: In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of laparoscopic cholecystectomy (LC) for non-severe disease remain a subject of ongoing debate. Aim: To prove which method - early or delayed LC - is the method of choice in the non-severe disease by examining rates of gallstone-related complications, dissection difficulty, conversion rate, morbidity, mortality, and length of hospital stay. Material and methods: We retrospectively analysed the data of patients diagnosed with non-severe ABP, who were followed and underwent LC in our department. Patients who met the inclusion criteria were divided in to the early (< 2 weeks) and the delayed groups (> 2 weeks). Results: The patients in the early and delayed groups (n = 43/39) were similar in terms of demographic characteristics, comorbidities, and severity of biliary pancreatitis. The mean time to surgery was 1.7 vs. 6.5 weeks in the early and late groups, respectively. Patients in the delayed group had a 17.9% readmission rate. The causes were acute pancreatitis (10.2%), cholangitis, and cholecystitis. The conversion and the difficult dissection rates were 11.6% vs. 12.8% and 13.95% vs. 20.51% in the early and delayed groups, respectively. Mortality was not observed in the groups. Morbidity rates were 4.6% vs. 5%, and mean length of hospital stay was 10 vs. 17 days in the early and delayed groups, respectively. Conclusions: Delayed LC increases the rate of biliary events and early LC does not increase the operative difficulty or morbidity in patients with ABP.