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Surgical Endoscopy

Published in:

01-02-2010

Early laparoendoscopic rendezvous for acute biliary pancreatitis: preliminary results

Authors: G. Borzellino, F. Lombardo, A. M. Minicozzi, M. Donataccio, C. Cordiano

Published in: Surgical Endoscopy | Issue 2/2010

Abstract

Introduction

Early restored patency of the papilla has been hypothesized to reduce complications and mortality of acute biliary pancreatitis. The aim of this study was to evaluate the role of urgent laparoscopic cholecystectomy with intraoperative cholangiography and rendezvous when necessary in acute biliary pancreatitis natural history.

Patients and methods

Patients observed in the early stage of an acute biliary pancreatitis were included in the study. Operative risk assessment based on American Society of Anesthesiologists (ASA) score allowed the performance of urgent laparoscopic cholecystectomy within 72 h from onset of symptoms in 55 patients and a delayed intervention during the same admission in 21 patients. Intraoperative cholangiography was performed in all cases, and clearance of common bile duct was performed by flushing when possible, or rendezvous when necessary. Evolution of pancreatitis was evaluated with clinical and radiological monitoring.

Results

Urgent laparoscopic cholecystectomy was performed in all cases without conversion. At intraoperative cholangiography common bile duct was free in 25 patients, a papillary spasm was observed in 9, and common bile duct stones in 21 patients. Patency of the papilla was restored by flushing in 13 patients, while a rendezvous was necessary in 17 patients. The rate of organ failure and pancreatic necrosis was 1.8%, overall mortality was 1.8%, and overall morbidity 21.8%. No infectious complications of peripancreatic collections were observed.

Conclusion

Urgent laparoscopic cholecystectomy with selective intraoperative rendezvous may be considered as a treatment option in the early stage of acute biliary pancreatitis.

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Title: Early laparoendoscopic rendezvous for acute biliary pancreatitis: preliminary results
Authors: G. Borzellino
F. Lombardo
A. M. Minicozzi
M. Donataccio
C. Cordiano
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 2/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-009-0580-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Early laparoendoscopic rendezvous for acute biliary pancreatitis: preliminary results

Abstract

Introduction

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusion

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