Background: Conventional surgical wisdom is that a patient with gallstone pancreatitis should have the gallbladder removed during their initial hospitalization. However, patients are now often discharged to await operating room availability.
Methods: A retrospective review of all cases of gallstone pancreatitis at the Foothills Hospital between 1992 and 1996 was undertaken. Patients with a first attack of mild gallstone pancreatitis were studied.
Results: In all, 164 patients were identified: 90 patients were discharged for readmission cholecystectomy (discharged group), and 74 patients had the cholecystectomy before discharge (in-hospital group). Over the 5-year time period the proportion of patients discharged for readmission cholecystectomy increased from 27% to 67% (p<0.01). The total number of days waited for operation was greater in the discharged group versus in-hospital group: 40+/-69 days versus 8+/-10 days respectively (mean+/-SD). There was a trend towards an increased total number of days in hospital in the in-hospital group, 15.5+/-17 days versus 10.7+/-16 days. In the discharged group 20% (18 of 90) of patients experienced an adverse event requiring readmission while awaiting operation. Three had documented recurrent pancreatitis, 10 experienced recurrent pain, and 5 developed acute cholecystitis. There were no deaths in either group.
Discussion: Twenty percent of patients with gallstone pancreatitis who are discharged to await operating room time (average wait 40 days) will require readmission for biliary symptoms.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2020563 | PMC |
| http://dx.doi.org/10.1080/13651820310001135 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association Between High-Density Lipoprotein Cholesterol and Length of Hospital Stay in Acute Pancreatitis: A Retrospective Cohort Study.
Int J Gen Med
December 2024
Department of Gastroenterology, Ningbo No. 2 Hospital, Ningbo, Zhejiang Province, 315010, People's Republic of China.
Background: Acute pancreatitis (AP) is a complex inflammatory disorder with varying degrees of severity, impacting patient recovery and healthcare resource utilization. The length of hospital stay (LOS) is a pivotal indicator of recovery, and identifying factors influencing LOS can offer insights into AP management. High-density lipoprotein cholesterol (HDL-C), known for its cardioprotective properties, has been posited to influence AP outcomes; however, its relationship with LOS remains unclear.
View Article and Find Full Text PDFDifficult cannulation during endoscopic retrograde cholangiopancreatography-needle-knife precut versus transpancreatic sphincterotomy on the basis of successful cannulation and adverse events.
Surg Endosc
December 2024
Department of Research and Development and Department of Surgery, Central Hospital, Region Kronoberg, Strandvägen 8, 351 85, Växjö, Sweden.
Article Synopsis
- This study compared two alternative techniques, transpancreatic sphincterotomy (TPS) and precut sphincterotomy (PCS), for accessing the biliary tree during difficult ERCP procedures.
- TPS showed higher successful cannulation rates (86.5%) compared to PCS (69.7%), but both were lower than the standard sphincterotomy control group (92.4%).
- Despite higher cannulation success, TPS was associated with more adverse events (24.1%) compared to PCS (18.8%) and the control group (15.5%), with increased rates of pancreatitis and perforation in the TPS group.
Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla.
Korean J Gastroenterol
December 2024
Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
Background/aims: Urgent endoscopic removal is required for gallstones impacted at the duodenal papilla. This study compared the clinical features of impacted papillary stones (IPS) with those of common bile duct stones without impaction.
Methods: This study analyzed a common bile duct stone database from 2017 to 2023, identifying patients with IPS.
Emergency cholecystectomy: risk factors and impact of delay on electively booked patients, a 5-year experience of a tertiary care center.
BMC Surg
December 2024
Department of Surgery-Surgical Oncology, Ministry of National Guard Health Affairs, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
Article Synopsis
- Gallstone disease significantly strains healthcare resources, particularly through emergency cholecystectomy, yet there's limited research on the risk factors that lead to such emergencies in patients scheduled for elective surgery.
- A study conducted in Jeddah, Saudi Arabia, analyzed 823 patients, revealing that 15.67% underwent emergency cholecystectomy, often due to longer waiting times and previous emergency department visits.
- Key findings indicated that patients with acute cholecystitis or pancreatitis, and those with multiple prior ED visits, are at a much higher risk of requiring emergency surgery.
Recurrent cholangitis due to an intrahepatic calculus caused by migrated coil for vascular embolization: A case report.
Medicine (Baltimore)
December 2024
Department of Hepatobiliary Pancreatic Surgery, Ehime University Graduate School of Medicine, Toon City, Ehime, Japan.
Article Synopsis
- Pseudoaneurysms can occur after hepatobiliary and pancreatic surgeries, and catheter interventions are typically the first step in treatment; however, complications from arterial embolization can arise.
- A case study of a 43-year-old male revealed that a dislodged embolization coil caused bile duct stone formation, leading to recurrent cholangitis after previous treatment for a hepatic artery pseudoaneurysm.
- The case highlights the need for clinicians to monitor embolization coil positions in patients and consider coil migration as a potential cause when diagnosing bile duct stones, especially following hepatic artery embolization.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!