Comparison of outcomes of early vs delayed cholecystectomy in acute biliary pancreatitis at a tertiary care hospital.

Abstract

Objective: To compare the mean length of hospital stay and frequency of conversion from laparoscopic to open in early versus delayed cholecystectomy in patients with moderate acute biliary pancreatitis. Study Design: Randomized Clinical Trial. Setting: Department of Surgery in Mayo Hospital Lahore. Period: 02-04-2022 to 02-04-2023. Methods: All the patients meeting the required criteria were included in the study. Patients were admitted through surgical emergency. Procedure was explained to patients/guardian and informed consent was taken. Patients were randomized by lottery method into two groups. Group A (early cholecystectomy EC) and group B (delayed cholecystectomy DC). Patients were operated and assessed postoperatively by the same operating surgeon to minimize the bias. Data of these patients was collected using a predesigned pro-forma containing details about demographic profile of the patient and severity of the disease. Duration of hospital stay of every patient in each group will be recorded. Frequency of conversion from laparoscopic to open cholecystectomy was noted. Smoking and BMI was taken as confounders. Results: Total of 60 patients (30 in each), mean age of EC group was 45.33±3.79 years and mean age of DC group 46.60±4.14 years. Distribution of BMI was 25.41+ 3.66 kg/m2 in early cholecystectomy group and 29.68+6.53 in delayed cholecystectomy group. (p=0.003) There were 52.0% (n=13) male in EC group and 48.6% (n=17) females in EC group and 48.0% (n=12) male in DC group and 51.4% (n=18) females. (p= 1.000). Mean length of hospital stay was 5.36+ 0.76 days in early cholecystectomy group and 8.96+0.76 days in delayed cholecystectomy group. (p=0.000), 22.2% (n=4) had conversion to open cholecystectomy in EC group and 77.8% (n=14) in DC group. Conclusion: We concluded that early laparoscopic cholecystectomy reduced the hospital stay and conversion to open cholecystectomy in patients with moderate acute biliary pancreatitis.