Año 2022 / Volumen 114 / Número 2
Original
Long-term outcome of patients with biliary pancreatitis not undergoing cholecystectomy. A retrospective study

96-102

DOI: 10.17235/reed.2021.7891/2021

Pablo Parra-Membrives, Ana García-Vico, Darío Martínez-Baena, José Manuel Lorente-Herce, Granada Jiménez-Riera,

Resumen
Background and objective: most acute pancreatitis cases are of biliary origin and cholecystectomy is recommended to prevent recurrence. However, some patients will never be referred for surgery. In this study, the long-term follow-up of this group of patients was reviewed. Methods: all new cases of biliary pancreatitis from January 2015 to December 2017 that did not undergo cholecystectomy were analyzed. Epidemiologic data and Charlson’s comorbidity index (CCI) were recorded. Recurrent episodes of pancreatitis or biliary events and mortality during the follow-up period were recorded. Results: a total of 104 patients were included in the study (30.4 % of all biliary pancreatitis cases) and the median age was 82 years (range, 27-96). Average CCI was 5 (range, 0-18) and the median follow-up period was 37 months (range, 1-70). A total of 41 patients (39.4 %) had gallstone-related complications. Twenty-three patients (22,1 %) had recurrent pancreatitis and 34 (32,7 %) developed biliary events. Twenty-five patients died during follow-up (24 %) but only in 6 (5,8 %) was death due to gallstone-related complications. Non-related mortality was 15.5 % in patients who refused surgery and 25 % in multiple-comorbidity patients. Conclusion: patients who did not undergo cholecystectomy were at high risk for biliary events and pancreatitis recurrence. Conservative treatment and surgical abstention should be individualized and reserved for patients with multiple comorbidities with a short life expectancy.
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Bibliografía
1. van Dijk SM, Hallensleben NDL, van Santvoort HC, et al. Acute pancreatitis: recent advances through randomised trials. Gut 2017;66(11):2024-32.
2. Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas 2006;33(4):323-30.
3. Crockett SD, Wani S, Gardner TB, et al. Committee AGAICG. American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis. Gastroenterology 2018;154(4):1096-101.
4. Kimura Y, Takada T, Kawarada Y, et al. JPN Guidelines for the management of acute pancreatitis: treatment of gallstone-induced acute pancreatitis. J Hepatobiliary Pancreat Surg 2006;13(1):56-60.
5. WGIAAP Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology 2013;13(4 Suppl 2):e1-15.
6. Garg SK, Bazerbachi F, Sarvepalli S, et al. Why are we performing fewer cholecystectomies for mild acute biliary pancreatitis? Trends and predictors of cholecystectomy from the National Readmissions Database (2010-2014). Gastroenterol Rep (Oxf) 2019;7(5):331-7.
7. Sargen K, Kingsnorth AN. Management of gallstone pancreatitis: effects of deviation from clinical guidelines. JOP 2001;2(5):317-22.
8. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013;62(1):102-11.
9. Griniatsos J, Karvounis E, Isla A. Early versus delayed single-stage laparoscopic eradication for both gallstones and common bile duct stones in mild acute biliary pancreatitis. Am Surg 2005;71(8):682-6.
10. van Baal MC, Besselink MG, Bakker OJ, et al. Timing of cholecystectomy after mild biliary pancreatitis: a systematic review. Ann Surg 2012;255(5):860-6.
11. da Costa DW, Dijksman LM, Bouwense SA, et al. Cost-effectiveness of same-admission versus interval cholecystectomy after mild gallstone pancreatitis in the PONCHO trial. Br J Surg 2016;103(12):1695-703.
12. da Costa DW, Bouwense SA, Schepers NJ, et al. Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): a multicentre randomised controlled trial. Lancet 2015;386(10000):1261-8.
13. Cameron DR, Goodman AJ. Delayed cholecystectomy for gallstone pancreatitis: re-admissions and outcomes. Ann R Coll Surg Engl 2004;86(5):358-62.
14. McCullough LK, Sutherland FR, Preshaw R, et al. Gallstone pancreatitis: does discharge and readmission for cholecystectomy affect outcome? HPB (Oxford) 2003;5(2):96-9.
15. El-Dhuwaib Y, Deakin M, David GG, et al. Definitive management of gallstone pancreatitis in England. Ann R Coll Surg Engl 2012;94(6):402-6.
16. Di Mauro D, Wijesurendere CN, Attanasio A, et al. Outcome of acute pancreatitis in octogenarians: A retrospective study. JGH Open 2020;4(3):461-5.
17. Mytton J, Daliya P, Singh P, et al. Outcomes Following an Index Emergency Admission With Cholecystitis: A National Cohort Study. Ann Surg 2021;274(2):367-74. DOI: 10.1097/SLA.0000000000003599
18. Hajibandeh S, Antoniou GA, Antoniou SA. Meta-analysis of mortality risk in octogenarians undergoing emergency general surgery operations. Surgery 2021;169(6):1407-16. DOI: 10.1016/j.surg.2020.11.027
19. Park Y, Hwang DW, Lee JH, et al. Clinical outcomes of octogenarians according to preoperative disease severity and comorbidities after laparoscopic cholecystectomy for acute cholecystitis. J Hepatobiliary Pancreat Sci 2020;27(6):307-14.
20. Bonaventura A, Leale I, Carbone F, et al. Pre-surgery age-adjusted Charlson Comorbidity Index is associated with worse outcomes in acute cholecystitis. Dig Liver Dis 2019;51(6):858-63.
21. Lee JM, Chung WC, Sung HJ, et al. Factor analysis of recurrent biliary events in long-term follow up of gallstone pancreatitis. J Dig Dis 2017;18(1):40-6.
22. Stigliano S, Belisario F, Piciucchi M, et al. Recurrent biliary acute pancreatitis is frequent in a real-world setting. Dig Liver Dis 2018;50(3):277-82.
23. Kim SB, Kim TN, Chung HH, et al. Small Gallstone Size and Delayed Cholecystectomy Increase the Risk of Recurrent Pancreatobiliary Complications After Resolved Acute Biliary Pancreatitis. Dig Dis Sci 2017;62(3):777-83.
24. Kundumadam S, Fogel EL, Gromski MA. Gallstone pancreatitis: general clinical approach and the role of endoscopic retrograde cholangiopancreatography. Korean J Intern Med 2021;36(1):25-31.
25. García de la Filia Molina I, García García de Paredes A, Martínez Ortega A, et al. Biliary sphincterotomy reduces the risk of acute gallstone pancreatitis recurrence in non-candidates for cholecystectomy. Dig Liver Dis 2019;51(11):1567-73.
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Parra-Membrives P, García-Vico A, Martínez-Baena D, Lorente-Herce J, Jiménez-Riera G. Long-term outcome of patients with biliary pancreatitis not undergoing cholecystectomy. A retrospective study. 7891/2021


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Recibido: 13/02/2021

Aceptado: 22/04/2021

Prepublicado: 05/05/2021

Publicado: 07/02/2022

Tiempo de revisión del artículo: 41 días

Tiempo de prepublicación: 81 días

Tiempo de edición del artículo: 359 días


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