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Acute biliary pancreatitis in cholecystectomised patients
1Department of General Surgery, Vocational School of Health Services, Istanbul Gelisim University, Istanbul, Turkey.
Gallstones remaining after gallbladder removal can cause acute pancreatitis months or years later. Early diagnosis and treatment with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) are crucial to prevent mortality.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Cholecystectomy is a common procedure.
- Post-cholecystectomy complications can occur, including biliary pancreatitis.
Purpose of the Study:
- To evaluate cases of acute biliary pancreatitis occurring after cholecystectomy.
- To analyze risk factors, treatment outcomes, and mortality associated with post-cholecystectomy pancreatitis.
Main Methods:
- Retrospective analysis of 44 patients with acute biliary pancreatitis post-cholecystectomy.
- Data collected included demographics, illness severity, time to pancreatitis, interventions (endoscopic sphincterotomy - ES), surgical procedures, hospitalization duration, and mortality.
Main Results:
- Mean age 60.14 years; 28:16 female:male ratio.
- Pancreatitis occurred a mean of 80.6 months post-cholecystectomy.
- 36 patients had stones/biliary sand in the common bile duct (choledochus) on ERCP; ES successful in 32.
- 4 patients had unsuccessful stone extraction; 3 underwent surgery, 1 died.
Conclusions:
- Bile duct stones can be asymptomatic for years post-cholecystectomy, later causing acute pancreatitis and mortality risk.
- Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) are standard treatments.
- Surgical exploration of the common bile duct is indicated if endoscopic treatments fail.
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