scholarly journals Surgical treatment of acute biliary pancreatitis

2021 ◽  
Vol 180 (1) ◽  
pp. 40-44
Author(s):  
A. Yu. Korolkov ◽  
A. A. Smirnov ◽  
D. N. Popov ◽  
M. M. Saadylaeva ◽  
T. O. Nikitina ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Pancreatic Duct ◽  
Single Step ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Surgical Interventions ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Pancreatic Duct Stenting

The objective was to improve the management of patients with acute biliary pancreatitis against the background of cholecystocholedocholithiasis.Methods and materials. 107 patients with acute biliary pancreatitis against the background of cholecystocholedocholithiasis were treated between 2017 and 2020 years. Patients suffering from mild and moderately severe acute biliary pancreatitis underwent single-step (laparoscopic cholecystectomy with endoscopic papillosphincterotomy) or two-step (endoscopic papillosphincterotomy with delayed laparoscopic cholecystectomy) surgical interventions. Patients with severe acute pancreatitis underwent endoscopic papillosphincterotomy with or without common bile duct and pancreatic duct stenting. The comparative analysis was made to estimate the efficiency of different surgical interventions in different groups of patients.Results. Patients with mild or moderately severe acute biliary pancreatitis showed better outcomes after single-step surgical intervention. Patients with severe acute biliary pancreatitis – after endoscopic papillosphincterotomy with common bile duct and pancreatic duct stenting.Conclusion. Single-step surgical interventions (laparoscopic cholecystectomy with endoscopic papillosphincterotomy) are shown for patients with mild or moderately severe acute biliary pancreatitis, because this approach helps to preserve the complications, specific for two-step interventions. The single-step approach authentically helps to decrease the duration of hospital stay and reduce treatment costs. The two-step approach is shown for patients with severe acute biliary pancreatitis, but endoscopic papillosphincterotomy with lithoextraction should be supplemented by common bile duct and pancreatic duct stenting, in order to reduce the number of complications associated with delayed cholecystectomy.

Early versus Delayed Single-Stage Laparoscopic Eradication for Both Gallstones and Common Bile Duct Stones in Mild Acute Biliary Pancreatitis

2005 ◽  
Vol 71 (8) ◽  
pp. 682-686 ◽  
Author(s):  
John Griniatsos ◽  
Evangelos Karvounis ◽  
Alberto Isla
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Single Stage ◽  
Definitive Treatment ◽  
Morbidity Rate ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Laparoscopic Management ◽  
Significant Difference

Several studies addressed that preoperative endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct (CBD) clearance, followed by interval laparoscopic cholecystectomy (two-stage approach), constitutes the most common practice in cases of uncomplicated mild acute biliary pancreatitis. Between June 1998 and December 2002, 44 patients (35 females and 9 males with a median age of 62 years) suffering from uncomplicated mild acute biliary pancreatitis were treated in our unit. All patients were electively submitted to surgery after subsidence of the acute symptoms, and for definitive treatment we favored the single-stage laparoscopic management, avoiding preoperative ERCP. All patients underwent laparoscopic cholecystectomy plus fluoroscopic intraoperative cholangiogram (IOC). If filling defect(s) were detected in the IOC, a finding suggestive of concomitant choledocholithiasis, laparoscopic common bile duct exploration (LCBDE) was added in the same sitting. Twenty patients were operated upon within 2 weeks since the attack of the acute symptoms and constitute the early group (n = 20), whereas 24 patients underwent an operation later on and constitute the delay group (n = 24). We retrospectively compare the safety, effectiveness, and outcome after the single-stage laparoscopic management between the two groups of patients. Laparoscopic cholecystectomy alone constituted the definitive treatment in 38 patients, while an additional LCBDE was performed in the remaining 6 patients (14%), and all operations were achieved laparoscopically. There was no statistically significant difference between the groups in terms of operative time, incidence of concomitant choledocholithiasis, morbidity rate, and postoperative hospital stay. During the follow-up, none of the patients experienced recurrent pancreatitis. In uncomplicated mild acute biliary pancreatitis cases, a single-stage definitive laparoscopic management, avoiding preoperative ERCP, can be safely performed during the same admission, after the improvement of symptoms and local inflammation. Postoperative ERCP should be selectively used in patients in whom the single-stage method failed to resolve the problem.

Usefulness of endoscopic ultrasonography of the common bile duct in acute biliary pancreatitis

2000 ◽  
Vol 118 (4) ◽  
pp. A160
Author(s):  
Prat Frederic ◽  
Edery Joel ◽  
Meduri Bruno ◽  
Ayoun Charles ◽  
Bodart Michel ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Ultrasonography ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
The Common

scholarly journals Presence of choledocholithiasis in patients undergoing cholecystectomy for mild biliary pancreatitis

2016 ◽  
Vol 15 (4) ◽  
pp. 517-521
Author(s):  
Sumita Pradhan ◽  
JN Shah
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stone ◽  
Bile Duct Stone ◽  
Medical Science ◽  
Common Bile Duct Stones ◽  
Biliary Pancreatitis ◽  
Bile Duct Stones ◽  
Acute Biliary Pancreatitis ◽  
The Common

Background: Standard recommendations for patients recovering from an episode of biliary pancreatitis include cholecystectomy with intra operative cholangiogram or ERCP during the same hospital admission as it is believed that the instigating factor is the passage of stones through the common bile duct. As ERCP is not widely available and expensive, cholecystectomy with IOC is routinely performed to rule out choledocholithiasis. However detection of common bile duct stones is challenging. Whether these patients undergoing cholecystectomy require direct common bile duct evaluation is controversial.Objectives: To see the presence of common bile duct stones in patients with resolving acute mild biliary pancreatitis.Materials and Methods: Patients admitted in the surgical ward in Patan and Bir hospital with the diagnosis of mild acute biliary pancreatitis that underwent cholecystectomy with intra operative cholangiography from August 2010 to July 2011 were studied. The outcome of cholangiogram was analyzed together with findings of Common bile duct exploration.Result and Conclusion: A total of 52 patients with acute mild biliary pancreatitis were operated during this period. The Common bile duct stone was found in 1.9%. Out of four patients with abnormal cholangiogram, only one patient (25%) had stone on exploration, rest of the three cases (75%) had negative exploration. The presence of common bile duct stone in case of mild acute biliary pancreatitis undergoing cholecystectomy is very low (1.96%), and thus policy of selective IOC should be applied for cases with mild biliary pancreatitis.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.517-521

EARLY VERSUS DELAYED LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS

2021 ◽  
Vol 50 (3) ◽  
pp. 1811-1824
Author(s):  
Ahmed Eid Saad El-Fayoumi ◽  
Mohammad Ahmad Abd El-Gawad ◽  
Walid Raafat Abd El-Atey
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Delayed Laparoscopic Cholecystectomy

scholarly journals Endoscopic retrograde cholangio-pancreatograhy and laparoscopic cholecystectomy in single session management of acute biliary pancreatitis

2017 ◽  
Vol 4 (10) ◽  
pp. 3218
Author(s):  
Ahmed Gaber ◽  
Mohamed S. Ammar ◽  
Hatem Soltan
Keyword(s):  
Acute Pancreatitis ◽  
Laparoscopic Cholecystectomy ◽  
Single Step ◽  
University Hospital ◽  
Biliary Pancreatitis ◽  
Single Session ◽  
Endoscopic Retrograde ◽  
Acute Biliary Pancreatitis ◽  
Laboratory Investigations ◽  
A Prospective Study

Background: World widely, the annual incidence of acute pancreatitis ranges from 5 to 50 per 100000. The major cause of acute pancreatitis is biliary calculi, which occur in 50-70% of patients. Aim of this study is to evaluate Endoscopic Retrograde Cholangio-Pancreatography (ERCP) and Laparoscopic Cholecystectomy (LC) as a single step management of early acute biliary pancreatitis.Methods: A prospective study included 25 patients complaining of acute biliary pancreatitis. The study was done between December 2012 and February 2016 at Menofia University Hospital. All patients had acute biliary pancreatitis with obstructive jaundice proved by laboratory investigations and imaging. ERCP and LC in the same session were aimed in all patients. Results: Successful same session was done in 24 (96%) cases and 1 (4%) case failed (just had ERCP only). Twenty cases (80%) were females and five cases (20%) were males. By ERCP, multiple small stones were extracted in 15 (60%) cases, biliary mud in 3 (12%) cases, a big stone in 2 (8%) cases and no stones were extracted in 5 (20%) cases. During laparoscopic cholecystectomy, bile stained ascites was present in 15 (60%) cases and absent in 9 (36%) cases. Calcium soap in 7 (28%) cases and absent in 17 (68%) cases. 17 (68%) patients stayed 24 hours in hospital while 6 (24%) patients stayed 48 hours and 2 (8%) cases stayed 72 hours. No mortality was recorded.Conclusions: ERCP and LC as a single step is a good option for management of early acute biliary pancreatitis.

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