Randomized controlled trial of early versus late cholecystectomy in patients with mild acute pancreatitis

The optimal timing of laparoscopic cholecystectomy (LC) in mild acute biliary pancreatitis (MABP) remains debated. This study compared early (within 72 h) versus delayed LC outcomes.

A randomized trial at Zhejiang Hospital assigned 120 MABP patients to early or delayed LC. Demographics, complications, operative outcomes, and hospital stay were analyzed.

There were no differences in baseline demographics, overall complication rates (10 % vs. 8.3 %; P = 0.752), intraoperative blood loss (33.93 ± 17.68 mL vs. 37.08 ± 30.97 mL; P = 0.593) or conversion to open surgery rate (3.3 % vs. 5.0 %; P = 1.00) between the two groups. There were no recurrent biliary events, postoperative readmissions, reoperations, or deaths in either group; However, the early LC group demonstrated significant advantages in intraoperative adhesions (80 % vs. 93.3 %; P < 0.05), procedure time (61.87 ± 12.54 vs. 66.77 ± 12.11 min, P < 0.05) and the length of hospital stay (5 days vs. 7 days, P < 0.05).

For patients with MABP, early LC performed within 72 h of admission significantly reduces hospital length of stay and procedure time, without increasing perioperative complication rates or measures of procedural difficulty.