Cholecystectomy before hospital dismissal is advised for most cases of acute biliary pancreatitis (ABP). Surgery is often delayed in the setting of pancreatic necrosis to ensure stabilization of associated fluid collections and absence of potentially complicating inflammation. The optimal interval for safe and effective cholecystectomy in this group of patients is not well-defined. <\/p>\n\n\n\n
The Dutch Pancreatitis Study Group undertook this post hoc analysis of their multicenter prospective cohort of patients with ABP to identify (1) the interval to surgery with the lowest risks for both surgical complications and recurrent biliary events and (2) the benefit of clinically indicated endoscopic sphincterotomy during the preoperative interval. <\/p>\n\n\n\n
All 248 patients from 27 centers had ABP with a CT severity score of >3 and were dismissed from the hospital with intact gallbladders. Overall, 191 patients (77%) subsequently underwent cholecystectomy, most within 46 to 222 days (median, 103 days). One-quarter of these patients underwent an open cholecystectomy. Recurrent pancreatitis prior to cholecystectomy occurred in 9% of patients, whereas overall biliary events occurred in 27% of all patients, and 35% of those going on to cholecystectomy. The risk of recurrent ABP was lower in the first 8 weeks following dismissal (risk ratio [RR], 0.14; P<\/em>=.02), and overall biliary events were significantly lower within 10 weeks of dismissal than thereafter (RR, 0.49; P<\/em>=.02). Endoscopic biliary sphincterotomy failed to reduce the rate of recurrent ABP or overall biliary events (odds ratio, 1.40; 95% confidence interval, 0.74-2.83). Four patients (2%) developed infected necrosis following cholecystectomy, all of whom had persistent fluid collections less than 2 weeks before surgery. Overall surgical complication rates did not decline over time.<\/p>\n","protected":false},"excerpt":{"rendered":" Cholecystectomy before hospital dismissal is advised for most cases of acute biliary pancreatitis (ABP). Surgery is often delayed in the setting of pancreatic necrosis to ensure stabilization of associated fluid collections and absence of potentially complicating inflammation. The optimal interval for safe and effective cholecystectomy in this group of patients is not well-defined. The Dutch … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,67],"tags":[3083,3082,3081,3084,2128],"class_list":["post-11346","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-bauchspeicheldruese-pankreas","tag-abp","tag-acute-biliary-pancreatitis","tag-cholecystectomy","tag-dutch-pancreatitis-study","tag-pancreatobiliary"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/11346","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=11346"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=11346"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=11346"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}