Abstract Background/Aims Patients with acute gallstone pancreatitis should undergo laparoscopic cholecystectomy during the index admission or within two weeks1. Patient fitness, patient choice and service availability are factors that affect the interval between diagnosis and surgery. Our aim was to assess for adverse outcomes for those waiting more than the recommended two weeks. A secondary objective was to appraise whether surgery during index admission causes harm. Methods The electronic notes of all patients with acute gallstone pancreatitis were retrospectively reviewed. Diagnostic imaging including ultrasound, CT scans and MRCP scans were also reviewed. These patients were followed up for at least 12 months to assess for further presentations with pancreatitis Results 54 patients were admitted with gallstone pancreatitis in a 12-month period. There were 40 female and 14 male patients with an age range between 16 – 92 years (median= 56). 41 patients were a candidate for surgery. Six patients had further attacks of pancreatitis whilst waiting for surgery. None of those six patients required escalation to level two or three care. Of those deemed not a candidate for surgery (due to medical co-morbidity or patient choice) none had further attacks of pancreatitis requiring presentation to emergency services. Conclusion The ideal timing of laparoscopic cholecystectomy in acute gallstone pancreatitis has been controversial2. Our findings demonstrate a relatively low risk of recurrent attacks for those that wait more than two weeks. This may be sufficient time to peri-operatively optimise the patient and allow intrabdominal inflammation to settle before cholecystectomy is performed.
Rahman et al. (Fri,) studied this question.