Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis

A randomized prospective study

Shir Li Jee, Razman Jarmin, Kin Foong Lim, Krishnan Raman

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. Methods: Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group. Recurrent biliary events, peri-operative complications, conversion rate, length of surgery and total hospital length of stay between the two groups were evaluated. Results: A total of 72 patients were enrolled at a single public hospital. Of them, 38 were randomized to the early group and 34 patients to the delayed group. There were no differences regarding peri-operative complications (7.78% vs 11.76%; . p = 0.700), conversion rate to open surgery (10.53% vs 11.76%; . p = 1.000) and duration of surgery performed (80 vs 85 minutes, . p = 0.752). Nevertheless, a greater rate of recurrent biliary events was found in the delayed group (44.12% vs 0%; . p ≤ 0.0001) and the hospital length of stay was longer in the delayed group (9 vs 8 days, . p = 0.002). Conclusion: In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.

Original languageEnglish
JournalAsian Journal of Surgery
DOIs
Publication statusAccepted/In press - 18 Apr 2016

Fingerprint

Cholecystectomy
Pancreatitis
Prospective Studies
Length of Stay
Conversion to Open Surgery
Laparoscopic Cholecystectomy
Public Hospitals
Morbidity

Keywords

  • Biliary pancreatitis
  • Cholecystectomy
  • ERCP
  • Recurrent biliary events

ASJC Scopus subject areas

  • Surgery

Cite this

@article{844b7b86ee0c4153af8b6d97f36d5549,
title = "Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis: A randomized prospective study",
abstract = "Background: In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. Methods: Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group. Recurrent biliary events, peri-operative complications, conversion rate, length of surgery and total hospital length of stay between the two groups were evaluated. Results: A total of 72 patients were enrolled at a single public hospital. Of them, 38 were randomized to the early group and 34 patients to the delayed group. There were no differences regarding peri-operative complications (7.78{\%} vs 11.76{\%}; . p = 0.700), conversion rate to open surgery (10.53{\%} vs 11.76{\%}; . p = 1.000) and duration of surgery performed (80 vs 85 minutes, . p = 0.752). Nevertheless, a greater rate of recurrent biliary events was found in the delayed group (44.12{\%} vs 0{\%}; . p ≤ 0.0001) and the hospital length of stay was longer in the delayed group (9 vs 8 days, . p = 0.002). Conclusion: In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.",
keywords = "Biliary pancreatitis, Cholecystectomy, ERCP, Recurrent biliary events",
author = "Jee, {Shir Li} and Razman Jarmin and Lim, {Kin Foong} and Krishnan Raman",
year = "2016",
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day = "18",
doi = "10.1016/j.asjsur.2016.07.010",
language = "English",
journal = "Asian Journal of Surgery",
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publisher = "Elsevier Taiwan LLC",

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TY - JOUR

T1 - Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis

T2 - A randomized prospective study

AU - Jee, Shir Li

AU - Jarmin, Razman

AU - Lim, Kin Foong

AU - Raman, Krishnan

PY - 2016/4/18

Y1 - 2016/4/18

N2 - Background: In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. Methods: Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group. Recurrent biliary events, peri-operative complications, conversion rate, length of surgery and total hospital length of stay between the two groups were evaluated. Results: A total of 72 patients were enrolled at a single public hospital. Of them, 38 were randomized to the early group and 34 patients to the delayed group. There were no differences regarding peri-operative complications (7.78% vs 11.76%; . p = 0.700), conversion rate to open surgery (10.53% vs 11.76%; . p = 1.000) and duration of surgery performed (80 vs 85 minutes, . p = 0.752). Nevertheless, a greater rate of recurrent biliary events was found in the delayed group (44.12% vs 0%; . p ≤ 0.0001) and the hospital length of stay was longer in the delayed group (9 vs 8 days, . p = 0.002). Conclusion: In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.

AB - Background: In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. Methods: Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group. Recurrent biliary events, peri-operative complications, conversion rate, length of surgery and total hospital length of stay between the two groups were evaluated. Results: A total of 72 patients were enrolled at a single public hospital. Of them, 38 were randomized to the early group and 34 patients to the delayed group. There were no differences regarding peri-operative complications (7.78% vs 11.76%; . p = 0.700), conversion rate to open surgery (10.53% vs 11.76%; . p = 1.000) and duration of surgery performed (80 vs 85 minutes, . p = 0.752). Nevertheless, a greater rate of recurrent biliary events was found in the delayed group (44.12% vs 0%; . p ≤ 0.0001) and the hospital length of stay was longer in the delayed group (9 vs 8 days, . p = 0.002). Conclusion: In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.

KW - Biliary pancreatitis

KW - Cholecystectomy

KW - ERCP

KW - Recurrent biliary events

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