Assessment of cholecystectomy status in patients admitted with acute biliary pancreatitis : a retrospective analysis

Abstract

Background : Gallstone pancreatitis constitutes 40% of all cases with pancreatitis while it constitutes up to 90% of cases with acute pancreatitis. Cholecystectomy is the definitive treatment for gallstones. Despite the recommendation for cholecystectomy in acute biliary pancreatitis considerable number of patients does not undergo cholecystectomy in our country. Objectives: To assess the status of cholecystectomy in patients admitted with acute biliary pancreatitis and to identify the reasons for not undergoing surgery. Materials and Methods : Patients admitted with diagnosis of acute biliary pancreatitis in our hospital between June 2016 and May 2017 were retrospectively reviewed. Data of demographic details, severity of pancreatitis, status of cholecystectomy, duration of hospital stay, method of cholecystectomy, reasons for not undergoing cholecystectomy,recurrence of acute pancreatitis in patients who did not undergo cholecystectomy was collected. Results: Total of 50 patients with acute biliary pancreatitis was included in the study. Totally 18 (36%) patients underwent cholecystectomy and most of the patients underwent surgery by laproscopic method. Most common reason for not undergoing cholecystectomy was patients being lost to follow up 24 (75%) following discharge. Among the patients who did not undergo cholecystectomy 5 patients had recurrence of pancreatitis and 2 patients had moderate to severe pancreatitis. Conclusion: This retrospective analysis shows that 32 (64%) of patients with acute biliary pancreatitis did not undergo cholecystectomy. The predominant reason for not undergoing cholecystectomy was being lost to follow up following discharge. Patients should be counseled about the risk and possible complications of not undergoing cholecystectomy and as much possible cholecystectomy should be considered in th same admission itself.