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[Celioscopic treatment of cholelithiasis in benign acute biliary pancreatitis]
L Guibert1, J C De Watteville, F Gayral
1Service de Chirurgie Générale et Digestive, CHU de Bicêtre, Le Kremlin-Bicêtre.
Objectives And Methods:
To evaluate the laparoscopic treatment of cholelithiasis in mild acute gallstone pancreatitis, 35 patients with gallstone pancreatitis and less than 4 Ranson's prognostic signs at 48 h were retrospectively included.
Results:
Eight patients underwent preoperative endoscopic retrograde cholangiopancreatography. Surgery was performed a median of 15 (range: 4-60) days after the onset of pancreatitis, and included laparoscopic cholecystectomy with intraoperative cholangiography that was successful in 30 out of 32 cases (93%). A common bile duct stone was present in 4 patients (11%). Conversion to open surgery was necessary in 3 patients (8%). Choledocholithiasis was successfully removed by laparoscopy in two cases, and by laparotomy and postoperative endoscopic sphincterotomy in one case each.
Conclusion:
Laparoscopic treatment can be recommended as the primary treatment within a few days after the onset of mild gallstone pancreatitis.