Study of laparoscopic cholecystectomy in gallstones induced pancreatitis

Authors

  • Abhinav Bisht Department of General surgery, Himalayan institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India
  • Babar Rehmani Department of General surgery, Himalayan institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/2349-2902.isj20181057

Keywords:

Gallstone induced pancreatitis, Laparoscopic cholecystectomy, Morbidity

Abstract

Background: Many general surgeons still harbor a notion that laparoscopic cholecystectomy in patients with acute gallstone induced pancreatitis has a higher morbidity. The timing of cholecystectomy in these patients is a matter of debate. Aim of the study was to assess the degree of difficulty, the timing of laparoscopic cholecystectomy (LC), and the complications of surgery in patients of gall stone pancreatitis subjected to laparoscopic cholecystectomy.

Methods: 69 patients were diagnosed with gall stone induced pancreatitis over a period of 12 months and 46 underwent laparoscopic cholecystectomy. After an acute attack of pancreatitis the procedure was performed on index admission or was delayed for an interval of 3 to 4 weeks, thereby dividing the study sample into two on the basis of timing of surgery. The severity of pancreatitis was graded according to the Revised Atlanta criteria.

Results: All the patients who underwent laparoscopic cholecystectomy had either mild or moderate severity of pancreatitis. Comparing the two groups with regard to timing of cholecystectomy, no statistically significant difference was noted in operating time, difficulty in surgery, conversion rate to open procedure or post-operative stay.

Conclusions: Laparoscopic cholecystectomy in patients with gallstone induced pancreatitis does not attribute any additional risk and does not have increased morbidity nor is there any increase risk of conversion.

References

Tonsi AF, Bacchion M, Crippa S, Malleo G, Bassi C. Acute pancreatitis at the beginning of the 21st century: The state of the art. World J Gastroenterol. 2009;15(24):2945-59.

Corfield AP, Cooper MJ, Williamson RC. Acute pancreatitis: a lethal disease of increasing incidence. Gut. 1985;26(7):724-9.

Sbarounis CN. Did Alexander the Great die of acute pancreatitis? J Clin Gastroenterol. 1997;24:294-6.

Soper NJ, Brunt LM, Callery MP. Role of laparoscopic cholecystectomy in the management of acute gallstone pancreatitis. Am J Surg. 1994;167:42-50.

Shaheen NJ, Hansan RA, Morgan DR. Burden of gastroenterology and liver disease. Am J Gastro. 2006;101:2128-38.

Thoeni RF. The Revised Atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment. 2012;262:21-7.

Mentula PJ, Leppäniemi AK. Applicability of the Clavien-Dindo classification to emergency surgical procedures: a retrospective cohort study on 444 consecutive patients. Surgery. 2014;8:31-7.

Wani PM, Shah RA. Study of outcome of early vs delayed laparoscopic cholecystectomy in mild and moderate acute gallstone pancreatitis. Int Surg. 2014;99(1):56-61.

Falor AE, de Virgilio C, Stabile BE. Early Laparoscopic Cholecystectomy for Mild Gallstone Pancreatitis Time for a Paradigm Shift. Arch Surg. 2012;147(11):21-7.

Johnstone M, Royle TJ, Richardson CE, Hepburn E, et al. The impact of timing of cholecystectomy following gallstone pancreatitis. Surgeon. 2014;12(3):134-40.

Nebiker CA, Frey DM. Early versus delayed cholecystectomy in patients with biliary acute pancreatitis. Surgery. 2009;145(3):260-4.

Al-Qahtani HHA. Early versus interval cholecystectomy after mild acute gallstone pancreatitis: A 10 year experience in central Saudi Arabia. J Taibah Univ Med Sci. 2014;9(4):322-7.

Hershkovitz Y, Kais H. Interval laparoscopic cholecystectomy: what is the best timing for surgery? IMAJ. 2016;18:10-2.

Rai MA, Aslam MF. Safety of early laparoscopic cholecystectomy in mild to moderate acute pancreatitis. J Rawalpindi Med Coll. 2016;20(4):278-80.

Perez LJ, Parra JF, Dimas GA. The safety of early laparoscopic cholecystectomy (<48 h) for patients with mild gallstone pancreatitis: A systemic review of the literature and meta analysis. Cirugía Española (English Edition). 2014; 92(2):107-13.

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Published

2018-03-23

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Section

Original Research Articles