Biliary surgery in the same admission for gallstone-associated acute pancreatitis

Osborne, D. H.; Imrie, C. W.; Carter, D C

doi:10.1002/bjs.1800681103

Cited by 203 publications

(59 citation statements)

References 7 publications

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“…According to several authors operation can be performed at the acute phase, while according to others it should be performed several weeks after the acute episode [17][18][19][20][21][22][23]. In our series the preferred time of the operation was within 72 hours from the acute episode.…”

Section: Discussionmentioning

confidence: 98%

Acute gallstone pancreatitis: a constant challenge for the surgeon

Papavramidis¹,

Zandes²,

Hatzimisios³

et al. 2008

Indian J Surg

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Section: Discussionmentioning

confidence: 98%

Acute gallstone pancreatitis: a constant challenge for the surgeon

Papavramidis¹,

Zandes²,

Hatzimisios³

et al. 2008

Indian J Surg

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“…The evidence that does exist originates mainly from older retrospective studies that observed no recurrent ABP after a cholecystectomy compared with a 25% to 61% rate of ABP recurrence with conservative management [11][12][13][14][15][16][17]. From a retrospective population-based cohort study, it was concluded that a cholecystectomy reduces the risk of a recurrent or de novo ABP almost to the same level as found in the general population [18].…”

Section: Cholecystectomy Versus Conservative Treatmentmentioning

confidence: 99%

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

et al. 2009

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Background Recurrent attacks of acute biliary pancreatitis (RABP) are prevented by (laparoscopic) cholecystectomy. Since the introduction of endoscopic retrograde cholangiopancreaticography (ERCP), several series have described a similar reduction of RABP after endoscopic sphincterotomy (ES). This report discusses the different treatment options for preventing RABP including conservative treatment, cholecystectomy, ES, and combinations of these options as well as their respective timing. Methods A search in PubMed for observational studies and clinical (comparative) trials published in the English language was performed on the subject of recurrent acute biliary pancreatitis and other gallstone complications after an initial attack of acute pancreatitis. Result Cholecystectomy and ES both are superior to conservative treatment in reducing the incidence of RABP. Cholecystectomy provides additional protection for gallstone-related complications and mortality. Observational studies indicate that cholecystectomy combined with ES is the most effective treatment for reducing the incidence of RABP attacks.Conclusion From the literature data it can be concluded that ES is as effective in reducing RABP as cholecystectomy but inferior in reducing mortality and overall morbidity. The combination of ES and cholecystectomy seems superior to either of the treatment methods alone. A prospective randomized clinical trial comparing ES plus cholecystectomy with cholecystectomy alone is needed.Keywords Acute biliary pancreatitis Á Cholecystectomy Á Endoscopic sphincterotomy Á ERCP Á Recurrent Acute biliary or gallstone pancreatitis (ABP) is an inflammatory condition of the pancreas induced by gallstones [1]. The initial treatment of ABP can be either conservative or interventional. The coexistence of cholangitis is an accepted indication for the performance of endoscopic retrograde cholangiopancreaticography (ERCP). However, whether this procedure is performed for patients with ABP depends on local expertise and guidelines, as is the decision to perform an endoscopic sphincterotomy (ES) [2][3][4][5].After patients have recovered from their first attack of ABP, most guidelines advocate a cholecystectomy to prevent a recurrent attack or other gallstone-related disorders such as symptomatic choledocholithiasis, cholecystitis, gallstone ileus, jaundice, and cholangitis [2][3][4][5]. ''Recurrent'' symptomatic choledocholithiasis after an initial attack of ABP may be preexisting common bile duct (CBD) stones not detected at the time of the primo episode or stones that migrated from the gallbladder into the CBD after initial stone clearance. Choledocholithiasis also may have developed newly within the bile duct after cholecystectomy.

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“…Mild cases failing to improve within a few days may also benefit from the procedure, especially in surgically high risk patients. When the pancreatitis has subsided, surgery during the same admission should be offered to those patients with gallbladder in situ [17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

The Role of Ercp in the Management of Gallstone-Associated Acute Pancreatitis: A Prospective Study of 64 Patients at Riyadh Central Hospital

et al. 1992

Ann Saudi Med

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In a prospective study, consecutive patients admitted to one of the surgical units at Riyadh Central Hospital with a diagnosis of acute biliary pancreatitis (ABP) underwent, after stabilization, urgent ERCP within 72 hours of admission. A total of 64 patients (35 males, 29 females) were treated over a four-year period (1986)(1987)(1988)(1989)(1990). Fortyeight patients were found to have common bile duct stones when endoscopic sphincterotomy (ES) and stone extraction was performed, including four patients with concomitant cholangitis. This was followed by a significant decrease in mean values of the biochemical parameters: serum amylase, SGOT, total bilirubin (P < 0.001) and alkaline phosphatase (P < 0.02), with a corresponding clinical improvement. Urgent ERCP+ES was not associated with any serious complications. There was no hospital mortality in this series. Details of the endoscopic findings and treatment are summarized. Based on the present study and others cited, the role of ERCP in the diagnosis and management of ABP are discussed and recommendations suggested.

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Biliary surgery in the same admission for gallstone-associated acute pancreatitis

Cited by 203 publications

References 7 publications

Acute gallstone pancreatitis: a constant challenge for the surgeon

Acute gallstone pancreatitis: a constant challenge for the surgeon

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

The Role of Ercp in the Management of Gallstone-Associated Acute Pancreatitis: A Prospective Study of 64 Patients at Riyadh Central Hospital

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