Timing of cholecystectomy after mild biliary pancreatitis: same-admission versus interval cholecystectomy
摘要
Acute pancreatitis, Inflammation of the pancreas, is a leading gastroenterology-related cause of hospital admissions and contributes significantly to morbidity and mortality in the United States. The treatment for acute gallstone pancreatitis, whose etiology is biliary pancreatitis, is cholecystectomy. It has been proven that gallbladder removal reduces the chances of recurrent gallstone-related complications. However, the question about the timing of the surgery is whether in the same hospitalization (within 72 h) or upon later timing. Thus, we decided to compare same-admission and interval cholecystectomy, hypothesizing that interval cholecystectomy would not increase the risk of recurrent gallstone-related complications.
Materials and methodsThis retrospective population-based cohort study. In the current study, we will utilize the database of Surgery A to detect and define biliary pancreatitis cases.
Study populationPatients who have undergone cholecystectomy as treatment of biliary pancreatitis cases treated at Soroka University Medical Center from 2017 through 2024.
Statistical analysisThe comparison of groups was conducted using Pearson Chi-square for categorical variables and Fisher’s exact test for dichotomous variables when applicable. Quantitative variables were compared using parametric and a-parametric tests. The probability value has been set as P < 0.05, and a multiple variable analysis will be conducted using logistical regression to pinpoint if the timing of surgery.
Results and discussionOne hundred forty-one patients met the criteria and were entered into the analysis. Primary analysis has shown that there was no difference between the two groups regarding basic demographics and has shown no significant difference between the groups. Like that, we did not find any significant difference between the groups regarding hospitalization days, complications, and re-admission. Thus, we conclude that even though we still advocate for the early and same-admission protocol for treating mild acute pancreatitis, if needed (due to reasons like COVID, war, etc.), one can delay the operation with no dire consequences.