Recurrence of Acute Gallstone Pancreatitis and Relationship with Cholecystectomy or Endoscopic Sphincterotomy

Hernandez, Vicent; Pascual, Isabel; Almela, Pedro; Añon, Ramon; Herreros, Belen; Sanchiz, Vicente; Minguez, Miguel; Benages, Adolfo
December 2004
American Journal of Gastroenterology;Dec2004, Vol. 99 Issue 12, p2417
Academic Journal
OBJECTIVES: To determine the prevalence of recurrence of gallstone pancreatitis, its clinical features, and the presence of prognostic factors of recurrence.METHODS: From January 1, 2000 to August 31, 2003, 233 patients admitted with acute gallstone pancreatitis (AGP) were prospectively studied. Patients were divided into two groups: recurrent and nonrecurrent group. Clinical, analytical, radiological, prognostic parameters, and severity (Atlanta criteria) were assessed, along with the performance of cholecystectomy or endoscopic sphincterotomy (ES). Clinical features of recurrence were analyzed. Univariate (χ2, Student'st-test) and multivariate tests were performed. Statistical significance was assumed ifp<0.05.RESULTS: Two hundred and eighty-six attacks were identified. Forty-two patients (18.2%) recurred, suffering 53 recurrent attacks, which took place within 30 days in 23.3%. Patients who did not undergo surgery after the first attack had 31-fold risk of recurrence (OR= 31.5%, CI= 95%[7.22–137.84],p<0.001). In patients not operated, recurrence was more frequent if ES was not performed (37.04%vs0%,p= 0.019). Among patients with surgical risk, none who recurred underwent ES, compared with 27.9% of those who did not recur. Patients in the nonrecurrent group underwent cholecystectomy within the first 30 days or ES more frequently (31.2%vs7.3%,p= 0.001).CONCLUSIONS: Recurrence of gallstone pancreatitis is a frequent event. Delay of cholecystectomy implies an increased risk of recurrence. ES could be an acceptable option to prevent recurrence in patients who are not candidates for surgery or who do not desire to undergo cholecystectomy.(Am J Gastroenterol 2004;99:2417–2423)


Related Articles

  • Outcome of cholecystectomy in diabetic patients. Ziaee, S. A.; Fanaie, S. A.; Khatib, R.; Khatibzadeh, N. // Indian Journal of Surgery;Apr2005, Vol. 67 Issue 2, p87 

    Background: Mortality and morbidity from gallstones in the diabetic patients in comparison with the nondiabetics are always controversial. Aims: To evaluate the risk factors associated with morbidity from gallstones. Materials and Methods: We have analyzed data from 669 cholecystectomies...

  • Small Gallstones Are Associated with Increased Risk of Acute Pancreatitis: Potential Benefits of Prophylactic Cholecystectomy? Venneman, Niels G.; Buskens, Erik; Besselink, Marc G. H.; Stads, Susanne; Go, Peter M. N. Y. H.; Bosscha, Koop; van Berge-Henegouwen, Gerard P.; van Erpecum, Karel J. // American Journal of Gastroenterology (Springer Nature);Nov2005, Vol. 100 Issue 11, p2540 

    OBJECTIVES: Pancreatitis is a severe complication of gallstone disease with considerable mortality. Small gallstones may increase the risk of pancreatitis. Our aims were to evaluate potential association of small stones with pancreatitis and potential beneficial effects of prophylactic...

  • Abdominal Wall Sinus: An Unusual Presentation of Spilled Gallstone. Chowbey, Pradeep K.; Goel, Amit; Bagchi, Nabanita; Sharma, Anil; Khullar, Rajesh; Soni, Vandana; Baijal, Manish // Journal of Laparoendoscopic & Advanced Surgical Techniques;Dec2006, Vol. 16 Issue 6, p613 

    Gallbladder perforation and spillage of bile is common during laparoscopic cholecystectomy. We report a case of an abdominal wall sinus due to a spilled gallstone presenting 10 years after laparoscopic cholecystectomy.

  • Biliary Complications Post Laparoscopic Cholecystectomy:Mechanism, Preventive Measures, and Approach to Management: A Review. Machado, Norman Oneil // Diagnostic & Therapeutic Endoscopy;2011, p1 

    Laparoscopic cholecystectomy has emerged as a gold standard therapeutic option for the management of symptomatic cholelithiasis. However, adaptation of LC is associated with increased risk of complications, particularly bile duct injury ranging from 0.3 to 0.6%. Occurrence of BDI results in...

  • Preoperative versus intraoperative endoscopic sphincterotomy for management of common bile duct stones. ElGeidie, Ahmed A.; ElEbidy, Gamal K.; Naeem, Yussef M. // Surgical Endoscopy;Apr2011, Vol. 25 Issue 4, p1230 

    Background: ERCP remains the prevailing method of treating CBDS; however, its ideal timing in respect to laparoscopic cholecystectomy (LC) is not defined. LC combined with intraoperative endoscopic sphincterotomy (IOES) was compared with preoperative endoscopic sphincterotomy (PES) followed by...

  • Abdominal symptoms: do they disappear after cholecystectomy? Berger, M. Y.; olde Hartman, T. C.; Bohnen, A. M. // Surgical Endoscopy;Nov2003, Vol. 17 Issue 11, p1723 

    Objective: To evaluate the effect of cholecystectomy in patients with gallstones on preoperative abdominal symptoms.Methods: A systematic search was made of the Medline database in combination with reference checking. Articles were excluded if patients aged <18 years,...

  • Removal of gallstone from mesorectum after laparoscopic cholecystectomy -- new indication for transanal endoscopic microsurgery technique. Szczepkowski, Marek; Przywózka, Alicja; Zieliński, Tomasz // Videosurgery & Other Miniinvasive Techniques / Wideochirurgia i;2015, Vol. 10 Issue 4, p580 

    Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for local excision of benign and malignant neoplasms in the rectum. Indications for this technique are constantly changing and extending. The aim of this study is to describe a case of a unique and innovative application...

  • Sequential endoscopic papillary balloon dilatation following limited sphincterotomy for common bile duct stones. Kochhar, Rakesh; Dutta, Usha; Shukla, Rajat; Nagi, Birinder; Singh, Kartar; Wig, Jai D. // Digestive Diseases & Sciences;Jul2009, Vol. 54 Issue 7, p1578 

    Endoscopic papillary balloon dilatation (EPBD) has been recently used in conjunction with endoscopic sphincterotomy (EST) for the removal of common bile duct (CBD) stones. The present study was aimed at assessing the safety and outcome of sequential EPBD following EST for CBD stones. A total of...

  • Endoscopic sphincterotomy for prevention of the recurrence of acute biliary pancreatitis in patients with gallbladder in situ. Vázquez-Iglesias, J.L.; B. González-Conde; L. López-Rosés; Estévez-Prieto, E.; P. Alonso-Aguirre; Lancho, A.; Suárez F., F.; Nunes, R. // Surgical Endoscopy;Oct2004, Vol. 18 Issue 10, p1442 

    Background: Endoscopic sphincterotomy without cholecystectomy is a therapeutic option in selected patients alter acute biliary pancreatitis. We conducted a prospective evaluation of the long-term effects of sphincterotomy in terms of the need For of subsequent cholecystectomy and the recurrence...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics