Comparison of Outcomes in Early versus Delayed Cholecystectomy in Patients of Acute Biliary Pancreatitis

Abstract

Objective: to compare the outcomes of early versus delayed cholecystectomy in patients of mild to moderate acute biliary pancreatitis.Study Design: Randomizd controlled trialPlace and duration: study was conducted in general surgery department of Lahore General Hospital Lahore, Services Hospital Lahore and Holy Family Hospital Rawalpindi from January 2017 to January 2018.Methodology: All the patients who were diagnosed as mild to moderate acute biliary pancreatitis and selected for cholecystectomy. Data collection was done via non probability consecutive sampling included patients’ demographics, conversion to open surgery, hospital stay and complications were assessed. Results: The mean duration of surgery and mean length of stay of early group was 90.00±3.55 minutes and 9.06±1.16 days, respectively. Conversion to open, overall complications, preoperative and postoperative was noted as 18%, 12%, 2% and 10%, respectively. Mortality was observed as 2%. While, the mean duration of surgery and mean length of stay of delayed group was 91.14±2.15 minutes and 9.88±2.24 days, respectively. Conversion to open, overall complications, preoperative and postoperative was noted as 14%, 14%, 6% and n=4 (8%), respectively. Mortality was observed as 6%.The differences were statistically significant for duration of surgery and length of stay (p=0.005) and (p=0.001), respectively.Conclusion: Results of our study reveal that patients of acute biliary pancreatitis treated with cholecystectomy at the index day have shorter hospital stay and less biliary events as compare to delayed cholecystectomy. Similarly conversion to open surgery, duration of surgery and complications are also less in early cholecystectomy.

Keywords: acute biliary pancreatitis, early cholecystectomy, delayed cholecystectomy, hospital stay, conversion to open surgery.