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2017 ; 4
(1
): 73-76
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Acute biliary pancreatitis in cholecystectomised patients
#MMPMID28752146
Ciftci F
; Anuk T
North Clin Istanb
2017[]; 4
(1
): 73-76
PMID28752146
show ga
OBJECTIVE: The present study is an evaluation of cases of acute biliary
pancreatitis that developed subsequent to cholecystectomy. METHODS: Total of 44
patients were assessed in this retrospective study. Demographic characteristics,
severity of illness, time elapsed between cholecystectomy and development of
pancreatitis, whether endoscopic sphincterotomy (ES) was performed, surgical
procedure used, duration of hospitalization, and mortality data were recorded.
RESULTS: Mean age of all patients was 60.14±16.4 years (range: 20-85 years), and
female:male ratio was 28:16. Mean length of time elapsed between cholecystectomy
and development of acute pancreatitis was 80.6 months (range: 5-230 months).
Gallstones and biliary sand were found in the choledochi of 36 patients upon
endoscopic retrograde cholangiopancreatography (ERCP), but not observed in the
remaining 8 patients. ES was performed and material was extracted in 32 of the 36
patients, but stone extraction was unsuccessful in 4 cases; 3 patients underwent
open surgery with choledochus exploration and 1 patient died. Excluding this
patient, mean duration of hospitalization was 7.5±2.5 days. CONCLUSION: Stones in
bile ducts may remain asymptomatic for long periods after cholecystectomy.
However, some stones trigger acute pancreatitis months or years after
cholecystectomy, causing risk of mortality. ERCP and ES are the standard
treatments. If these are unsuccessful, the choledochus may be explored via open
or laparoscopic surgery.