Post-laparoscopic cholecystectomy pancreatitis

Abstract

Laparoscopic cholecystectomy is one of the commonest operations performed on the biliary system. Acute pancreatitis following Lap-chole is quite uncommon. Whether pancreatitis is a complication or a sequalae to surgical treatment of gall stone disease continues to be a debatable issue. A 37-year-old lady underwent laparoscopic cholecystectomy for incidentally diagnosed gall stones. Early post-operative course was uneventful. The patient presented 3 weeks after surgery with severe excruciating abdominal pain and was diagnosed as acute pancreatitis by ultrasound evaluation. Liver function tests were altered with raised bilirubin, serum lipase and amylase. MRCP revealed a normal biliary tract. Pancreas showed changes of acute interstitial pancreatitis. Patient responded to conservative line of treatment. Acute pancreatitis could be a known complication following laparoscopic cholecystectomy. What causes pancreatitis continues to be a matter for debate. MRCP is the investigation of choice. Interventional endoscopy (ERCP) is indicated in cases of impacted gallstone in the CBD. While if the CBD is clear of stones, aggressive conservative management will suffice.