Outcomes of delayed vs early cholecystectomy in individuals diagnosed with acute biliary pancreatitis caused by gallstones.

Abstract

Objective: To conduct a comparative analysis of the outcomes associated with delayed cholecystectomy vs early cholecystectomy in individuals diagnosed with acute biliary pancreatitis caused by gallstones. Study Design: Randomized Clinical Trial. Setting: Department of General Surgery, Jinnah Postgraduate Medical Centre in Karachi, Pakistan. Period: March 2023 to August 2023. Methods: A total of 120 patients with mild to severe acute biliary pancreatitis were randomized into two groups: Group EC (early cholecystectomy) and Group DC (delayed cholecystectomy). Biliary leakage incidence and hospital stay duration were recorded. Chi-square and independent t-tests were used to analyze differences between groups, with a p-value <0.05 considered statistically significant. Results: The average age of the patients enrolled was 46.33 + 12.92 years. 62 (51.67%) were female, while 58 (48.33%) were male. The average dimension of gallstones was 6.65 x 2.37 mm. The average quantity of gallstones was 2.65 + 2.63. Patients who underwent delayed cholecystectomy spent an average of 5.47 days in the hospital, whereas those who underwent early cholecystectomy spent 4.351.18 days (p-value <0.0001). Biliary leakage was observed in three patients (5.0%) who underwent early cholecystectomy, compared to ten patients (16.7%) who underwent delayed cholecystectomy (p-value = 0.04). Conclusion: There is a correlation between early laparoscopic cholecystectomy and a reduced incidence of biliary leakage as well as a shorter duration of hospitalization. Patients with acute biliary pancreatitis may therefore safely undergo an early laparoscopic approach.