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Impact of obstructive jaundice on outcomes in acute biliary pancreatitis: a retrospective study
Roi Abramov1, Elena Derkach2, Boris Sokolovski3,4
1Department of General Surgery, Rambam Health Care Campus, HaAliya HaShniya 8, Haifa, Israel. RO_ABRAMOV@rambam.health.gov.il.
Objective:
To examine the effects of obstructive jaundice on the outcomes of patients with acute biliary pancreatitis.
Methods:
A retrospective chart review was conducted on 332 cases of acute biliary pancreatitis admitted to Rambam Health Care Campus, Israel, from January 1st, 2018, to December 31st, 2021. Patients were categorized based on the presence or absence of obstructive jaundice. Various clinical, laboratory, and radiological parameters were analyzed, including severity prediction scores, length of stay, interventions, and complications.
Results:
Obstructive jaundice was observed in 136 patients, while 196 patients had no jaundice. Initial predictive scores (Ranson and Glasgow-Imrie) indicated higher severity in the jaundiced group, but this difference did not translate into significant variations in the final outcomes. Endoscopic procedures and sonography were more frequently performed in jaundiced patients, affecting the diagnosis and management. Cholecystectomy was performed sooner in the jaundiced group, leading to fewer recurrent admissions.
Conclusion:
The outcomes of jaundiced and non-jaundiced patients with acute biliary pancreatitis were found to be similar, despite initial predictions of worse outcomes in the jaundiced population. A lower threshold for initiation of rigorous treatment, including more frequent endoscopic procedures, administration of antibiotics and early surgical intervention may facilitate these results. Further studies with a larger sample size and long-term follow-up are warranted to validate these findings.
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