Surgeons provide definitive care to patients with gallstone pancreatitis

Am J Surg. 2011 Dec;202(6):673-7; discussion 677-8. doi: 10.1016/j.amjsurg.2011.06.031. Epub 2011 Oct 19.

Abstract

Background: The optimal management of patients with gallstone pancreatitis (GP) remains a matter of debate. There are wide variations in the use of diagnostic testing and same-stay cholecystectomy. We hypothesize that a general surgery service (SURG) will deliver more efficient, definitive care for patients with GP.

Methods: A retrospective cohort study of consecutive GP patients in an urban hospital from 2006 to 2009. Differences between groups were assessed by the two-tailed Student t test for continuous variables and the Fisher exact test for ordinal data.

Results: One hundred twenty-four patients with GP were admitted, 79 to medicine (MED) and 45 to surgery (SURG). In the MED group, 21 patients (27%) underwent same-stay cholecystectomy, and 7 patients (9%) returned with recurrent biliary pancreatitis. In the SURG group, 44 patients had definitive surgery, and none returned with recurrent disease (P < .01 and .09, respectively). The SURG group had fewer laboratory tests, antibiotics, and consultations.

Conclusions: For patients with GP, admission to surgery results in definitive treatment with same-stay cholecystectomy. This is a more efficient approach with fewer readmissions for the same disease process.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholecystectomy / methods*
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Gallstones / complications
  • Gallstones / diagnosis
  • Gallstones / surgery*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreatitis / diagnosis
  • Pancreatitis / etiology
  • Pancreatitis / surgery*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult