The ideal timing of cholecystectomy for mild gallstone pancreatitis

Abstract

Background: Gallstone disease is one of the most common problems affecting the digestive tract with a prevalence of 11% to 36% and is the most common cause of gall stone pancreatitis. The cholecystectomy is necessary to prevent recurrent pancreatitis in gallstone pancreatitis, but the ideal timing for cholecystectomy is controversial.Methods: This was a prospective randomized study with 59 patients conducted in the department of general surgery, KIMS, Bangalore from 2014 to 2019. All patient with mild gallstone pancreatitis, the following variables, duration and cost of hospital stay, readmission rates, intraoperative time, intra and postoperative complications and conversion to open cholecystectomy were studied.Results: A total of 59 patients in the age group of 21 to 71 years with mild gallstone pancreatitis were included in the study. Mean age of presentation was 57years. Out of 59 patients 28 underwent same admission cholecystectomy and 31 underwent interval cholecystectomy. There was a significant difference noted in terms of mean duration of hospital stay (9.28 versus 17.20 days), mean cost of hospital stay (19340 versus 28240rs) and readmission rate (0% versus 19.35%), but in terms of mean intraoperative time (85 min versus 92 min) and conversion rate (0% versus 6.4%) there was no statistically significant difference between two group.Conclusions: Same admission cholecystectomy for mild gallstone pancreatitis can significantly reduce cost and duration of hospital stay and readmission rates. With regard to intraoperative time, conversion to open, intraoperative and postoperative complication there is no statistically significant difference seen. Hence same admission cholecystectomy is safe, feasible and recommended.