ASSESSMENT OF THE EARLY AND DELAYED CHOLECYSTECTOMY IN PATIENTS WITH ACUTE BILIARY PANCREATITIS
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Keywords
Acute biliary pancreatitis, early cholecystectomy, late cholecystectomy
Abstract
Background and Aim: Gallstone-related pancreatitis is a frequently encountered complication. Majority of individuals suffer from mild disease but progress to severe pancreatitis in 20% cases, elevating the likelihood of significant complications in recurring episodes. The present study aimed to compare the early versus delayed cholecystectomy in acute biliary pancreatitis patients.
Patients and Methods: A prospective randomized study was carried out on 80 acute biliary pancreatitis patients in the general surgery wards of several tertiary units in the United Kingdom from April 2022 to December 2022. De-identified patient data was obtained in this multi-centric study. Patients were categorized into two groups; Group-A (early cholecystectomy) and Group-B (late cholecystectomy). Peri-operative complications, surgery duration, recurrent biliary events, conversion rate, and total hospital stay were evaluated and compared in both groups. SPSS version 27 was used for descriptive statistics.
Results: The overall mean age of group-A and group-B was 40.82±14.62 and 46.38±16.64 years respectively. Majority of patients belonged to 31 to 50 years (35% (n=14) in early vs. 32.5% (n=13) in late group). Abdomen pain was the most prevalent presented complaint 100% (n=40) found in both groups. The pre and post-operative laboratory parameters such as ALT, ALP, and total bilirubin in early vs. late were 41.05±15.82 vs. 32.71±16.98, 182.42±62.63 vs. 112.06±18.72, and 1.05±0.58 vs. 0.64±0.14 respectively. About 80% (n=32) patients of early cholecystectomy took 60 to 75 minutes for intervention as compared to 75% (n=30) patients of late cholecystectomy 75 to 90 minutes. Mean hospital stay of early and late cholecystectomy group was 7.49±2.69 and 15.42±6.64 days respectively.
Conclusion: Early cholecystectomy significantly minimize the duration of surgery, risk of postoperative complications, recurrent biliary events, duration of surgery, and hospital stay in acute biliary pancreatitis as compared to late cholecystectomy.
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Swetha Sakthivel
Royal College of Surgeons Ireland
Ayesha Hanif
Medical Officer Anesthesia, Doctor's Hospital and Medical Centre, Lahore – Pakistan
Muhammad Mohsin Mansoor
House Officer, Federal Government Polyclinic Hospital, Islamabad - Pakistan
Inshaal Khalid
House Officer, CMH/MH, Rawalpindi – Pakistan
Abdullah Ahmed Almesri
Royal College of Surgeons in Ireland
Iqra Zulfiqar
Demonstrator Pharmacology, Mohi-ud-din Islamic Medical College, Mirpur - AJK