Objectives: It is still controversial to perform a laparoscopic cholecystectomy (LC) for the management of acute biliary pancreatitis (ABP) at the early hospitalization period, because of adhesions and dissection difficulties. The aim of this study was to evaluate the outcome of the patients with ABP who underwent LC prior to hospital discharge.
Methods: A total of 43 patients with ABP, that underwent LC after clinical and laboratory improvement, were retrospectively evaluated.Patient’s age, gender, laboratory findings; ultrasonography (USG), magnetic resonance and other imaging results, surgical operation duration, complications, mortality and postoperative hospital stay days were recorded and statistically analyzed.
Results: The median age of patients was 51.8 (20-83) years. A total of 29 (67.4%) patients were women and 14 (32.6%) were male. The cause was gallstone in all patients. In addition, hyperparathyroidism was found in one patient and hyperlipidemia was present in the other one. Gallbladder stones were determined in all patients. Common bile duct enlargement and stones were detected in 7 patients. Three patients underwent sphyncterectomy and stone extraction according to clinical status. Operations were performed at the mean hospitalization day of 11.4 (3-23). LC was performed to 39 (%90.6) of patients. However, 4 (9.4%) patients had intra-abdominal adhesions secondary to infection and were switched to open surgery. The mean operation time was 70 (25-160) minutes and the mean duration of postoperative hospital stay was 3 (1-6) days. In a patient who underwent LC and ERCP preoperatively complication occurred. A second drainage operation was performed and due to development of necrotizing pancreatitis, the patient was lost at the postoperative 7th day secondary to adult type respiratory distress syndrome.
Conclusions: In patients with ABP whose clinical and laboratory findings were improved, late LC can be performed safely during their first hospitalization.