Timing of cholecystectomy after mild biliary pancreatitis: same-admission versus interval cholecystectomy.

Introduction Acute pancreatitis, Inflammation of the pancreas, is a leading gastroenterology-related cause of hospital admissions and contributes significantly to morbidity and mortality in the United States. The treatment for acute gallstone pancreatitis, whose etiology is biliary pancreatitis, is cholecystectomy. It has been proven that gallbladder removal reduces the chances of recurrent gallstone-related complications. However, the question about the timing of the surgery is whether in the same hospitalization (within 72 h) or upon later timing. Thus, we decided to compare same-admission and interval cholecystectomy, hypothesizing that interval cholecystectomy would not increase the risk of recurrent gallstone-related complications.

This retrospective population-based cohort study. In the current study, we will utilize the database of Surgery A to detect and define biliary pancreatitis cases. Study population Patients who have undergone cholecystectomy as treatment of biliary pancreatitis cases treated at Soroka University Medical Center from 2017 through 2024. Statistical analysis The comparison of groups was conducted using Pearson Chi-square for categorical variables and Fisher’s exact test for dichotomous variables when applicable. Quantitative variables were compared using parametric and a-parametric tests. The probability value has been set as P < 0.05, and a multiple variable analysis will be conducted using logistical regression to pinpoint if the timing of surgery.

and discussion One hundred forty-one patients met the criteria and were entered into the analysis. Primary analysis has shown that there was no difference between the two groups regarding basic demographics and has shown no significant difference between the groups. Like that, we did not find any significant difference between the groups regarding hospitalization days, complications, and re-admission. Thus, we conclude that even though we still advocate for the early and same-admission protocol for treating mild acute pancreatitis, if needed (due to reasons like COVID, war, etc.), one can delay the operation with no dire consequences. Similar content being viewed by others Notes Duncan CB, Riall TS. Evidence-based current surgical practice: calculous gallbladder disease. J Gastrointest Surg. 2012 Nov;16(11):2011–25. https://doi.org/10.1007/s11605-012-2024-1. Epub 2012 Sep 18. PMID: 22,986,769; PMCID: PMC3496004.

Bhatia M, Wong FL, Cao Y, Lau HY, Huang J, Puneet P et al (2005) Pathophysiology of acute pancreatitis. Pancreatology 5(2–3):132 Frossard J, Steer ML, Pastor CM (2008) Acute pancreatitis. Lancet 371(9607):143–152 Garg SK, Sarvepalli S, Campbell JP, Obaitan I, Singh D, Bazerbachi F et al (2019) Incidence, admission rates, and predictors, and economic burden of adult emergency visits for acute pancreatitis. J Clin Gastroenterol 53(3):220 Venneman NG, van Brummelen SE, van Berge-Henegouwen GP, van Erpecum KJ (2003) Microlithiasis: an important cause of ‘idiopathic’ acute pancreatitis? Ann Hepatol 2(1):30–35 Lee SP, Nicholls JF, Park HZ (1992) Biliary sludge as a cause of acute pancreatitis. N Engl J Med 326(9):589–593 Da Costa DW, Bouwense SA, Schepers NJ, Besselink MG, Van Santvoort HC, Van Brunschot S et al (2015) Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): a multicentre randomised controlled trial. Lancet 386(10000):1261–1268 Bakker OJ, Van Santvoort HC, Hagenaars JC, Besselink MG, Bollen TL, Gooszen HG et al (2011) Timing of cholecystectomy after mild biliary pancreatitis. Br J Surg 98(10):1446 Johnstone M, Marriott P, Royle TJ, Richardson CE, Torrance A, Hepburn E et al (2013) The impact of timing of cholecystectomy following gallstone pancreatitis. Surgeon 12(3):134 Moody N, Adiamah A, Yanni F, Gomez D (2019) Meta-analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis. J Br Surg 106(11):1442–1451 Patel H, Jepsen J (2024) Gallstone disease: common questions and answers. Am Fam Phys 109(6):1 Padula D et al (2024) Practical approach to acute pancreatitis: from diagnosis to the management of complications. Intern Emerg Med. https://doi.org/10.1007/s11739-024-03666-9 Dang A (2023) Real-world evidence: a primer. Pharmaceut Med 37(1):25–36 Yokoe M, Takada T, Mayumi T, Yoshida M, Isaji S, Wada K, Itoi T, Sata N, Gabata T, Igarashi H, Kataoka K, Hirota M, Kadoya M, Kitamura N, Kimura Y, Kiriyama S, Shirai K, Hattori T, Takeda K, Takeyama Y, Hirota M, Sekimoto M, Shikata S, Arata S, Hirata K (2015) Japanese guidelines for the management of acute pancreatitis: Japanese guidelines 2015. J Hepatobiliary Pancreat Sci 22(6):405–432 Isaji S, Takada T, Mayumi T, Yoshida M, Wada K, Yokoe M, Itoi T, Gabata T (2015) Revised Japanese guidelines for the management of acute pancreatitis 2015: revised concepts and updated points. J Hepatobiliary Pancreat Sci 22(6):433–445 Hritz I, Czakó L, Dubravcsik Z, Farkas G, Kelemen D, Lásztity N, Morvay Z, Oláh A, Pap Á, Párniczky A, Sahin-Tóth M, Szentkereszti Z, Szmola R, Szücs Á, Takács T, Tiszlavicz L, Hegyi P, Magyar Hasnyálmirigy Munkacsoport, Hungarian Pancreatic Study Group (2015) Akut pancreatitis. A Magyar Hasnyálmirigy Munkacsoport bizonyítékon alapuló kezelési irányelvei [Acute pancreatitis. Evidence-based practice guidelines, prepared by the Hungarian Pancreatic Study Group]. Orv Hetil 156(7):244–261 da Costa DW, Schepers NJ, Römkens TE, Boerma D, Bruno MJ, Bakker OJ, Dutch Pancreatitis Study Group (2016) Endoscopic sphincterotomy and cholecystectomy in acute biliary pancreatitis. Surgeon 14(2):99–108 Podda M, Di Martino M, Ielpo B, Catena F, Coccolini F, Pata F, Marchegiani G, De Simone B, Damaskos D, Mole D, Leppaniemi A, Sartelli M, Yang B, Ansaloni L, Biffl W, Kluger Y, Moore EE, Pellino G, Di Saverio S, Pisanu A (2024) The 2023 MANCTRA acute biliary pancreatitis care bundle: a joint effort between human knowledge and artificial intelligence (ChatGPT) to optimize the care of patients with acute biliary pancreatitis in Western Countries. Ann Surg 279(2):203–212 CODA Collaborative, Flum DR, Davidson GH, Monsell SE, Shapiro NI, Odom SR, Sanchez SE, Drake FT, Fischkoff K, Johnson J, Patton JH, Evans H, Cuschieri J, Sabbatini AK, Faine BA, Skeete DA, Liang MK, Sohn V, McGrane K, Kutcher ME, Chung B, Carter DW, Ayoung-Chee P, Chiang W, Rushing A, Steinberg S, Foster CS, Schaetzel SM, Price TP, Mandell KA, Ferrigno L, Salzberg M, DeUgarte DA, Kaji AH, Moran GJ, Saltzman D, Alam HB, Park PK, Kao LS, Thompson CM, Self WH, Yu JT, Wiebusch A, Winchell RJ, Clark S, Krishnadasan A, Fannon E, Lavallee DC, Comstock BA, Bizzell B, Heagerty PJ, Kessler LG, Talan DA (2020) A randomized trial comparing antibiotics with appendectomy for appendicitis. N Engl J Med 383(20):1907–1919. https://doi.org/10.1056/NEJMoa2014320 van Baal MC, Besselink MG, Bakker OJ, van Santvoort HC, Schaapherder AF, Nieuwenhuijs VB et al (2012) Timing of cholecystectomy after mild biliary pancreatitis: a systematic review. Ann Surg 255(5):860–866 McDermott J, Kao LS, Keeley JA, Nahmias J, de Virgilio C (2024) Management of gallstone pancreatitis: a review. JAMA Surg 159(7):818–825 Moody N, Adiamah A, Yanni F, Gomez D (2019) Meta-analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis. Br J Surg 106(11):1442–1451 Gutt CN, Encke J, Köninger J, Harnoss JC, Weigand K, Kipfmüller K, Schunter O, Götze T, Golling MT, Menges M, Klar E, Feilhauer K, Zoller WG, Ridwelski K, Ackmann S, Baron A, Schön MR, Seitz HK, Daniel D, Stremmel W, Büchler MW (2013) Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304). Ann Surg 258(3):385–393. https://doi.org/10.1097/SLA.0b013e3182a1599b Siddiqui T, MacDonald A, Chong PS, Jenkins JT (2008) Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis of randomized clinical trials. Am J Surg 195(1):40–47. https://doi.org/10.1016/j.amjsurg.2007.03.004 da Costa DW, Dijksman LM, Bouwense SA, Schepers NJ, Besselink MG, van Santvoort HC, Boerma D, Gooszen HG, Dijkgraaf MG, Dutch Pancreatitis Study Group (2016) . Cost-effectiveness of same-admission versus interval cholecystectomy after mild gallstone pancreatitis in the PONCHO trial. Br J Surg 103(12):1695–1703. https://doi.org/10.1002/bjs.10222 Funding The current study received no Funding. Author information Authors and Affiliations Corresponding author Ethics declarations Disclosures Drs. Shadi Krime, MD and Abed Abu-Ganim, MD have no conflicts of interest or financial ties to disclose. Profs. Zvi Perry, MD, PhD and Itzhak Avital, MD, FACS have no conflicts of interest or financial ties to disclose. Sarai Sadeia, BSc has no conflicts of interest or financial ties to disclose. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Perry, Z., Sadeia, S., Krime, S. et al. Timing of cholecystectomy after mild biliary pancreatitis: same-admission versus interval cholecystectomy. Surg Endosc 39, 8647–8653 (2025). https://doi.org/10.1007/s00464-025-12290-3 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00464-025-12290-3