Outcomes of Early Verses Delayed Laparoscopic Cholecystectomy in Acute GallstoneInduced Pancreatitis Regarding Length of Hospital Stay and Conversion to Open Cholecystectomy
DOI:
https://doi.org/10.51985/Keywords:
Gallstones, Hospital stay. Laparoscopic cholecystectomy, PancreatitisAbstract
Objective: To compare the mean length of hospital stay and rate of conversion from laparoscopic to open in early versus delayed cholecystectomy in patients with acute Gallstone-Induced pancreatitis.
Study design and setting: A prospective comparative study was conducted in the Department of Surgery, Narowal Medical College, Narowal, from 07 January to 06 July 2025
Methodology: After the hospital's ethical committee approval, eighty patients with mild to moderate gallstone-induced
pancreatitis were randomly allocated into two groups: early cholecystectomy (EC) and delayed cholecystectomy (DC), 40 patients each. All surgeries were performed by the same surgical team. Length of hospital stay and conversion to open cholecystectomy were recorded. Data were analyzed using chi-square and independent t-tests, with p < 0.05 considered significant.
Results: Mean age was comparable between EC (45.40 ± 3.80 years) and DC (46.70 ± 4.00 years) groups (p = 0.29). The mean length of hospital stay was significantly shorter in the EC group (5.35 ± 0.80 days) compared with the DC group (8.90 ± 0.80 days) (p < 0.001). Conversion to open cholecystectomy occurred in 22.5% of EC patients versus 77.5% of DC patients (p < 0.001).
Conclusion: Early laparoscopic cholecystectomy significantly reduces hospital stay and conversion to open surgery compared with delayed cholecystectomy in mild to moderate gallstone-induced pancreatitis
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References
1. Szatmary P, Grammatikopoulos T, Cai W, Huang W, Mukherjee
R, Halloran C, Beyer G, Sutton R. Acute pancreatitis: diagnosis
and treatment. Drugs. 2022; 82(12):1251-76. https://doi.
org/10.1007/s40265-022-01766-4
2. Sohail Z, Shaikh H, Iqbal N, Masood H, Parkash O. Aetiology,
presentation and outcomes of patients presenting with acute
pancreatitis in a tertiary care hospital. J Pak Med Assoc. 2024;
74(3):563-5. https://doi.org/10.47391/JPMA.9279
3. Matta B, Gougol A, Gao X, Reddy N, Talukdar R, Kochhar
R, et al. Worldwide variations in demographics, management,
and outcomes of acute pancreatitis. Clin Gastroenterol Hepatol.
2020; 18(7):1567-75. https://doi.org/10.1016/j.cgh.2019.12.028
4. Mittal N, Oza VM, Muniraj T, Kothari TH. Diagnosis and
Management of Acute Pancreatitis. Diagnostics (Basel). 2025
Jan 23; 15(3):258 https://doi: 10.3390/diagnostics15030258.
PMID: 39941188; PMCID: PMC11816589.
5. Rajah H K. Current management of gallstone pancreatitis: a
narrative review. Asian J Med Health. 2024; 22:23-32.
https://doi.org/10.9734/ajmah/2024/v22i91087
6. Yuan X, Xu B, Wong M, Chen Y, Tang Y, Deng L, Tang D.
The safety, feasibility and cost-effectiveness of early
laparoscopic cholecystectomy for mild acute biliary
pancreatitis: a meta-analysis. Surgeon. 2021; 19(5):287-96.
https://doi.org/10.1016/j.surge.2020.06.014
7. Prasanth J, Prasad M, Mahapatra SJ, Krishna A, Prakash O,
Garg PK, Bansal VK. Early versus delayed cholecystectomy
for acute biliary pancreatitis: a systematic review and metaanalysis. World J Surg. 2022; 46(6):1359-75. https://doi.org/
10.1007/s00268-022-06501-4
8. Hallensleben ND, Timmerhuis HC, Hollemans RA, Pocornie
S, van Grinsven J, van Brunschot S, et al.; Dutch Pancreatitis
Study Group. Optimal timing of cholecystectomy after
necrotising biliary pancreatitis. Gut. 2022; 71(5):974-82.
https://doi.org/10.1136/gutjnl-2021-324239
9. Di Martino M, Ielpo B, Pata F, Pellino G, Di Saverio S, Catena
F, et al.; MANCTRA-1 Collaborative Group. Timing of
cholecystectomy after moderate and severe acute biliary
pancreatitis. JAMA Surg. 2023; 158(10):e233660.
10. Zainab H, Aslam M, Shah N. A study of early laparoscopic
cholecystectomy in mild acute gallstone pancreatitis. Saudi
Surg J. 2024; 12(1):27–33. doi:10.4103/ssj.ssj_2_22
11. Zaidi AH, Taimur M, Naqvi S, Ullah S, Faridi MA. Safety
and efficacy of early cholecystectomy in acute biliary
pancreatitis. J Islamabad Med Dent Coll. 2023; 12(4):982.
https://doi.org/10.35787/jimdc.v12i4.982
12. Alburakan AA, Alshunaifi AI, AlRabah RN, Alshammari SA,
Aloraini AM, Nouh TA, et al. Early versus delayed
cholecystectomy in biliary pancreatitis: experience from a
local acute care surgery unit. Medicine (Baltimore). 2023;
102(48):e36491. https://doi.org/10.1097/ MD.00000000000
36491 PMID: 38050277; PMCID: PMC10695525.
13. Wu H, Liao B, Cao T, Ji T, Huang J, Luo Y, Ma K. Comparison
of the safety profile, conversion rate and hospitalization
duration between early and delayed laparoscopic
cholecystectomy: a systematic review and meta-analysis.
Front Med (Lausanne). 2023; 10:1185482. https://doi.
org/10.3389/fmed.2023.1185482
14. Jaiswal SP, Upadhya PS, Paudel S, Thapaliya I, Awale L,
Adhikary S, et al. Early versus delayed laparoscopic
cholecystectomy for acute mild biliary pancreatitis: a
prospective comparative study. Int J Surg Open. 2024; 62:708-
12. https://doi.org/10.1097/IO9.0000000000000194
15. Piele SM, Preda SD, Pãtra?cu ?, Laskou S, Sapalidis K,
Dumitrescu D, ?urlin V. Indication and timing of
cholecystectomy in acute biliary pancreatitis – systematic
review. Curr Health Sci J. 2024; 50(1):125-32.
https://doi.org/10.12865/CHSJ.50.01.16
16. Qureshi R, Khan B, Kumar R, Mandhan P, Dawach A, Memon
AH. Outcomes of delayed vs early cholecystectomy in acute
biliary pancreatitis caused by gallstones. Prof Med J. 2025;
32(10):1235-41. https://doi.org/10. 29309/TPMJ/
2025.32.10.9618
17. Akram S, Khalid H, Muhi-ud-din Z, Imran M, Rashid F,
Fawad M. Optimal timing to perform cholecystectomy in
patients with acute biliary pancreatitis. J Health Rehabil Res.
2024; 4(3):1523. https://doi.org/10.61919/jhrr.v4i3.1523
18. Robertson FP, Dennison AR, Pandanaboyana S. Optimal
timing of cholecystectomy for severe acute pancreatitis and
understanding complications and comorbidities. JAMA Surg.
2024; 159(4):466-7. https://doi.org/10.1001/ jamasurg.2023.
6932
19. Mikwar Z, Aljadani FF, Alotaibi AK, Neazy FA, Alsaadi NH,
Alzahrani MA, Awadh A. The Conversion Rate of
Laparoscopic Cholecystectomy to Open Cholecystectomy at
King Abdulaziz Medical City, Jeddah, Saudi Arabia: Prevalence
and Causes. Cureus. 2024 Jun 24; 16(6):e63026. doi:
10.7759/cureus.63026. PMID: 39050302; PMCID:
PMC11267824
20. Ahmad, M. S., Mehmood, S., Kareemullah, M., Rashid, M.,
Hameed, B., Imran, H. M., & Hamad Ullah, R. (2024). Acute
Biliary Stone-Induced Pancreatitis: The Outcomes of Early
vs. Delayed Laparoscopic Cholecystectomy: Early Versus
Delayed Cholecystectomy. Pakistan Journal of Health Sciences,
5(09), 213–218. https://doi.org/10.54393/pjhs.v5i09.2110
21. Chandak, U., Pind, V., Mitra, A., Bansod, P. Y., Gaikwad, U.,
& Ramteke, P. (2022). Early versus late laparoscopic
cholecystectomy in acute biliary pancreatitis: a prospective
randomised study. International Surgery Journal, 9(9),
1559–1565. https://doi.org/10.18203/2349-2902.isj20222059
22. Walayat S, Baig M, Puli SR. Early vs late cholecystectomy
in mild gallstone pancreatitis: an updated meta-analysis. World
J Clin Cases. 2021; 9(13):3038-47. https://doi.org/10. 12998/
wjcc.v9.i13.3033
23. Fugazzola P, et al. Clinical update on acute cholecystitis and
biliary pancreatitis: between certainties and grey areas.
eClinicalMedicine (Lancet). 2024; (Article in press).
https://doi.org/10.1016/j.eclinm.2024.102241
24. Faur M, Fleaca SR, Gherman CD, Bacila CI, Tanasescu D,
Serban D, et al. Optimal timing and outcomes of minimally
invasive approach in acute biliary pancreatitis. Med Sci Monit.
2022; 28:e937016. https://doi.org/10.12659/MSM.937016
25. Alotaibi AE, Khan MK, Alobaysi ST, Alotaibi AH, Altammar
M, Albedaiwi SA, Al-Osaimi OA, Alrasheed AM, Alotaibi
AM. Outcomes of early versus delayed cholecystectomy in
acute gallstone pancreatitis: a systematic review and metaanalysis. Cureus. 2025 Oct 17; 17(10):e94793.
doi:10.7759/cureus.94793. PMID: 41250738; PMCID:
PMC12619953
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