Laparoscopic cholecystectomy for acute gallstone pancreatitis without jaundice:Report of 95 cases / 中国微创外科杂志

ABSTRACT

Objective To explore the feasibility and the selection of laparoscopic cholecystectomy(LC) for the treatment of acute gallstone pancreatitis(AGP) without jaundice.Methods Laparoscopic cholecystectomy had been performed in 95 patients with AGP accompanying no jaundice from July 1996 to July 2004 in this hospital.All of the patients had a history of conservative treatment.Selective LC was performed in 79 patients after their symptoms were relieved,while emergent LC was required in 16 patients because of failure of response to conservative treatment.Results All the operations were successfully completed.The operation time was 40~328 min(mean,103 min),and the intraoperative blood loss was 0~210 ml(mean,35 ml). Intraoperative cholangiography was carried out in all the 95 patients and succeeded in 92.Thirteen patients were found having lower common bile duct stones and then were cured with endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic spincterotomy(EST).No conversion to open operation was required.No postoperative biliary hemorrhage or leakage occurred.No fatal case was seen.Pathological examinations following operation revealed multiple small or sand-like stones in the gallbladder.Follow-up in 39 patients for 1 months ~ 5 years found no recurrence of pancreatitis or cholelithiasis.Conclusions Laparoscopic cholecystectomy should be performed as early as possible in the treatment of AGP without jaundice.Use of intraoperative cholangiography and postoperative EST should be emphasized in proper cases.