To Evaluate the Early Versus Delayed Cholecystectomy in Patients with Mild to Moderate Acute Biliary Pancreatitis: A Randomised Prospective Study

Authors

  • Dr. Pulkit Bhalla, Dr. Nikunj Bhesaniya, Dr. A.Y. Kshirsagar

Abstract

Aim: To evaluate the early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis.

Methods: 80 patients were included in the study. They were divided into two groups with 40 patients in each group. Group A: (40) patients who underwent laparoscopic cholecystectomy after 48 hours from day of admission. Group B: (40) patients who discharged home after resolution of the acute phase and underwent laparoscopic cholecystectomy after 6 weeks. Both groups were compared as regard: operative time, intraoperative findings and complications, conversion to open surgery, use of abdominal drains, hospital stay, post operative complications, readmission after discharge.

Results:  The mean age of patients in group A was 36.29 ± 10.33 years (range= 20-55 year) while in group B     was 37.58 ± 10.22 y (range= 20- 53 y). The majority of the patients were female. 24 patients (60%) in group A and 32 patients (80%) in group B. In group A the operative time ranged from 46 minutes to 89 minutes with a mean of 67.5±11.69 minutes, while in group B operative time ranged from 39 minutes to 76 minutes with a mean of 57.5±9.98 minutes . P value was significant 0.014. In group A 5 patients (12.5%) have intraoperative finding of acute cholecystitis where as none of group B express acute cholecystitis intraoperatively, with no statistically difference (p value 0.069). There was no significant difference in intraoperative complications between both groups. The difference between the two groups is significant (0% vs. 40%, p < 0.0001). 7 patients (17.5%) required hospital readmission due to severity of the symptoms. 10 patients (25%) had biliary colic, 3 patients (7.5%) developed acute cholecystitis, and 4 patients (10%) had recurrent biliary pancreatitis.

Conclusion:  We concluded that the early cholecystectomy in patients with mild acute biliary pancreatitis has no added risk of intra or post operative complications than delayed cholecystectomy. Also it significantly reduces the risk of recurrent biliary problems and length of hospital stay which has a great impact on the patients and health care resources.

Downloads

Published

2022-02-03