Complications of early Cholecystectomy in acute Biliary Pancreatitis
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Abstract
Introduction: Pancreatitis, inflammation of pancreas, is an acute emergency having mortality rate 2 to 7%. Acute pancreatitis can be caused by various factors, like drugs, alcohol, toxins, gallstones, trauma, infection etc. and amongst these, gallstones are the most common cause and is seen in around 75% of the cases. Regarding gall stones, the size of it and number are important parameters. Management usually depends upon the clinical scenario, underlying conditions of pancreas, presence of co morbid conditions and cholecystectomy. This can be done immediately or with an interval while the acute episode of pancreatitis is settled; each having their own benefits and complication rates.
Objective: To determine the complications of early cholecystectomy in acute biliary pancreatitis.
Methodology: A descriptive cases series study was carried out at Mayo Hospital Lahore during June through December 2017. The cases of either gender aged 18 years and above of acute biliary pancreatitis diagnosed clinically with epigastric pain, tenderness and vomiting with raised pancreatic enzymes with history of gall stones were selected purposively. The cases underwent open laparoscopic cholecystectomy in the same admission within 5 days of admission. These subjects were then followed to lo ok for duration of surgery, duration of hospital stay and recurrence of pancreatitis. Final outcome was seen at 3 months to look for recurrence.
Results: We took 50 cases of acute biliary pancreatitis. There were 20 (40%) males and 30 (60%) females. The mean age at presentation was 43.56± 4.68 years. The mean duration of surgery was observed as 54.56 ±12.33 minutes. Total complications were seen in 9 (18%) of the cases; few had combination of these. The most common complication seen was prolonged duration of hospital stay (18%), followed by prolonged duration of surgery (10%) and recurrent pancreatitis (8%).
Conclusion: Early cholecystectomy has higher compilations rate and the most common is long duration of hospital stay.
Key words: Pancreatitis, Early cholecystectomy
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