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Imtiaz Ali Soomro
Saiqa Rafiq
Sumaira Otho
Muhammad Hayat
Imam Alam
Abdul Rehman


laparoscopic early cholecystectomy, acute gallstone-induced pancreatitis, adults, prognosis


Background: About 75% of cases of acute pancreatitis in affluent countries are caused by gallstones. The biliopancreatic system's persistent obstructions, which cause the pancreas to gradually inflame, are the main cause of acute gallstone-induced pancreatitis. After an acute gallstone-induced pancreatitis episode, there may be recurrent pancreatitis episodes, common bile duct blockage, acute cholangitis episodes, or sporadic episodes of controllable biliary colic. Cholecystectomy is delayed until the local problems are treated, when severe pancreatitis with consequences such as pancreatic necrosis and organ failure are noted. The goal of early cholecystectomy is to reduce the risk of recurrent severe acute gallstone-induced pancreatitis, which is associated with serious health problems and an increased death rate. On the other hand, because early cholecystectomy is linked to a greater likelihood of complications and mortality, many surgeons often favour delayed cholecystectomy.

Objective: Examine the differences between patients receiving early versus delayed cholecystectomy for mild to moderate acute gallstone-induced pancreatitis (AGP) in terms of surgical duration, perioperative complications, conversion rate, length of hospital stay, and recurrence of gallstone-related disorders.

Study design: A Randomized controlled trial

Place and Duration: This study was conducted in Peoples University of Medical and Health Sciences Nawabshah from September 2022 to September 2023

Methodology: The participants of this study were aged 18 years and older. All of the patients were presented to the Department of General Surgery. All of the participants were diagnosed with mild-to-moderate AGP. Random sampling was used to place patients into two groups: early cholecystectomy (EC) and late cholecystectomy (LC). On a premade form, data on preoperative, intraoperative, and postoperative progress was gathered. Fisher's exact test was used to compare data with dichotomous variables that were reported as percentages. A P-value of less than 0.05 was seen as significant.

Results: A total of 100 patients were selected for this study because they met the inclusion criteria for this research. All of the individuals were diagnosed with acute gallstone-induced pancreatitis. The average age was 45.1 years. The age of the participants ranged from 18 to 75 years, respectively. Patients were divided into 2 groups: the EC (Early cholecystectomy) group and the DC (Delayed cholecystectomy) group, with each having 50 patients. The number of recurrent biliary events was 0 in the EC group, while it was 15 in the DC group.

Conclusion: The most effective method of treatment for AGP is a laparoscopic early cholecystectomy, which is safe and practical after the acute period.


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1. Khalid M. Mild To Moderate Acute Gallstone Pancreatitis: A Comparative Study of Early Versus Delayed Cholecystectomy. Journal of Surgery Pakistan. 2018 Aug 20;23(2):45-50.
2. Al-Qahtani HH. Early versus interval cholecystectomy after mild acute gallstone pancreatitis: A 10 year experience in central Saudi Arabia. Journal of Taibah University Medical Sciences. 2014 Dec 1;9(4):322-7.
3. Marwah S, Garg A, Goyal H, Singla S, Gurawalia JP. Presentation and Outcome of Gall Stone Pancreatitis in A Tertiary Care Center in North India. Indian Journal of Health Sciences and Care. 2020;7(1):6-13.
4. ALSHAMY AE, HATEM SS, KAMAL ME, MOHAMMED I. Comparative Study between Early versus Delayed Laparoscopic Cholecystectomy in Mild Acute Gallstone Pancreatitis. The Medical Journal of Cairo University. 2021 Dec 1;89(December):2571-81.
5. Sharma R, Devkaran B, Sharma S, Ohri A, Chaudhary R. Early Versus Delayed Laparoscopic Cholecystectomy In Patients With Mild Acute Biliary Pancreatitis. Annals of International Medical and Dental Research. 2018;4(6):5.
6. Mageed SA, Helmy MZ, Redwan AA. Acute mild gallstone pancreatitis: timing of cholecystectomy. International Surgery Journal. 2019 Mar 26;6(4):1051-5.
7. Gao Y, Lim SH, Chee YM, Iyer S, Madhavan K, Kow AW. Outcomes of Early Cholecystectomy for Patients with Acute Gallstone Pancreatitis. Journal of the American College of Surgeons. 2016 Oct 1;223(4):e141.
8. Khiali R, Ammari S, Nait Slimane N, Drai K, Haicheur EH, Taieb M. Early versus Delayed Cholecystectomy after Mild to Moderate Acute Biliary Pancreatitis: Results of a Comparative Prospective Study. World J Surg Surgical Res. 2022; 5.;1362.
9. Satishkumar R, Anukethan J. The ideal timing of cholecystectomy for mild gallstone pancreatitis. International Surgery Journal. 2020;7(1):253-7.
10. Moody N, Adiamah A, Yanni F, Gomez D. Meta-analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis. Journal of British Surgery. 2019 Oct;106(11):1442-51.
11. Uhl W, Warshaw A, Imrie C, Bassi C, McKay CJ, Lankisch PG et al. IAP Guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2e:565-73.
12. Neoptolemas JP. The theory of persisting common bile duct stones in severe gallstone pancreatitis. Ann R Coll Surg Engl. 1989;71:326-31.
13. Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Gastroenterology. 2007; 132:2022-44.
14. Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-400.
15. Soffer D, Blackbourne LH, Schulman CI, et al. Is there an optimal time for laproscopic cholecystectomy in acute cholecystectomy? Surg Endosc. 2007;21:805-9
16. Hammad HA. Early versus interval cholecystectomy after mild acute pancreatitis: A 10 year experience in central Saudia Arabia. J Taibah Uni Med Sci. 2014;9:322-7.
17. Sekimoto M, Takada T, Kawarada Y, Hirata K, Mayumi T, Yoshida M, et al. JPN guidelines for the management of acute pancreatitis: epidemiology, etiology, natural history, and outcome predictors in acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006;13:10- 24.
18. Jee SL, Jarmin R, Lim KF, Raman K. Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis: A randomized prospective study. Asian J Surg. 2018;41:47-54.
19. Rai MA, Aslam MF, Aslam S. Safety of Early Laparoscopic cholecystectomy in mild to moderate acute pancreatitis. J Rawalpindi Med Coll. 2016;20:278-80.
20. Stevens KA, Chi A, Lucas LC, Porter JM, Williams MD. Immediate laparoscopic cholecystectomy for acute cholecystectomy: no need to wait. Am J Surg. 2006;192:756- 61.

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