Safety and Efficacy of Early Cholecystectomy in Acute Biliary Pancreatitis

Abstract

Objective: This study was done to assess the safety and efficacy of early Cholecystectomy in mild to moderate Acute Biliary pancreatitis in own surgical setup.

Methodology: This descriptive study was done in surgical unit 1, Fauji Foundation Hospital Rawalpindi from 1st January 2019 to 31st December 2022. Total 70 patients diagnosed as having mild or moderate acute biliary pancreatitis were included in study. Patients having severe acute biliary pancreatis, multi-organ dysfunction syndrome and pre-existing severe medical co-morbidity were excluded from study. After informed consent early cholecystectomy either laparoscopic or open was performed by senior consultant surgeon within 2-4 days of admission. Post-operatively patient subjective feeling of pain, intravenous analgesia and hospital stay were recorded. Post-operative complications were documented. Data were analyzed on SPSS version 26.

Results: The age range was from 28 to 72 years with a mean of 45.2 ± 11.86 years. Majority of patients were of mild severity 44(62.9%), while 26(37.1%) cases were of moderate severity. Laparoscopic cholecystectomy was performed 28(40%) cases and open cholecystectomy was done in 38(54.28%) cases. Post-operative pain numerical scale mean was 4.31 ± 1.55. The duration of requirement of post-operative intravenous analgesia was mean 37.02 ± 18.12 hrs. Mean hospital stay of patients was 5.95 ± 1.39 days. Among post-operative complications, the most frequent was post prandial dyspepsia 10(14.3%) cases followed by surgical site infection 6(8.6%) cases, recurrent pancreatitis 4(5.7%) cases, pseudocyst formation 2(2.9%) cases, lobar pneumonia 1(1.4%) case and recurrent biliary sepsis in 1(1.4%) case.

Conclusion: Early cholecystectomy is a safe surgical procedure in mild to moderate biliary pancreatitis. It shortens the course of illness, prevents complications and reduces hospital stay.

KEYWORDS: Cholelithiasis, Acute biliary pancreatitis, cholecystectomy, safety, Efficacy.