Index Admission Laparoscopic Cholecystectomy for Gall Stone Pancreatitis.
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Date
2016-03
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Abstract
Background: Timing of Laparoscopic Cholecystectomy (LC) after gallstone pancreatitis varies considerably between
surgeons.We examined outcomes at JN Medical College and hospital where most patients underwent LC following
initial management of gallstone pancreatitis. Methods: This prospective study is carried out between June2009 to June
2013 in J.N.M.C.H. Patients with signs and symptoms of acute pancreatitis were admitted and evaluated. All patients
admitted were provided the standard care. After exclusion of some patients, remaining underwent laparoscopic
cholecystectomy irrespective of severity of disease in index admission, although patients with severe biliary pancreatitis
were operated after stabilization of general condition. Results: A total of 134 patients with gallstone pancreatitis were
identified of whom 90 underwent laparoscopic cholecystectomy (LC) in the index admission.77 patients were of mild
pancreatitis while 13 were of severe pancreatitis. Out of 77 patients with mild pancreatitis 8 patients and 6 out of 13
patients with severe pancreatitis had a difficult dissection (p value<0.05).In terms of hospital stay mean duration of stay
was 8.7 days in mild pancreatitis group, whereas it is 19.8 days in severe pancreatitis group (p value <0.05). Of these
90 patients79 (88%) underwent LC successfully while 11 (12%) required conversion to open cholecystectomy where 8
were of mild and 3 were of severe pancreatitis. 14 (15%) had a difficult dissection, where 8 were of mild and 6 were of
severe pancreatitis There were 6 (6.7%) postoperative complications in form of wound infection and bile leak overall.
The difference in terms of variables like conversion rate to open surgery, need of drain placement, bile leak and wound
infection was statistically not significant.Conclusion: LC should be used for GSP during the same hospital admission
with favorable outcome with complications and conversion rate compared to elective LC. All patients of mild pancreatitis
and patients of severe pancreatitis with no local and systemic complications could undergo laparoscopic
cholecystectomy in index admission.
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Keywords
Gallstone pancreatitis, index admission, laparoscopic cholecystectomy
Citation
Akhtar Mohd Sadik, Ali Wasif Mohammad, Khan Tausif Ahmed, Raza Mohammad Habib, Ahmed Manzoor. Index Admission Laparoscopic Cholecystectomy for Gall Stone Pancreatitis. Annals of International Medical and Dental Research. 2016 Mar-Apr; 2(2): 148-152.