An audit of the timing of cholecystectomy after index presentation of gallstone pancreatitis and the implications on morbidity, readmissions and operative complications.
This study is a continuation of a pilot study carried out at Walsall Manor, Russells Hall and New Cross Hospitals, with the results presented at the WMSS meeting Summer 2009. The pilot study suggested it may be safe to leave patients up to 6 weeks before definitive treatment of gallstones following an admission with acute gallstone pancreatitis.
The idea was taken from the previously published recommendations from the UK working party guidelines on acute pancreatitis which included the following statement regarding timing of cholecystectomy in patients with proven gallstone-induced pancreatitis:
“All patients with biliary pancreatitis should undergo definitive management of gall stones during the same hospital admission, unless a clear plan has been made for definitive treatment within the next two weeks. (Recommendation grade C).”
Delayed cholecystectomy in patients with proven gallstone pancreatitis does not result in increased morbidity and risk of readmission to hospital.
Early cholecystectomy in patients with gallstone pancreatitis does not result in a higher rate of operative complications such as conversion to open operation or wound infection.
- Retrospective notes-based review
- All patients (of any age) presenting with a new confirmed diagnosis of gallstone pancreatitis
- Primary outcome measure is the duration (days) from discharge after index admission with gallstone pancreatitis until date of cholecystectomy, as compared alongside any documented readmissions or A+E attendances with biliary colic/jaundice/pancreatitis.
- After a suitable patient list is formed, then patient notes are reviewed to aid the completion of a standardised, computer read proforma that will be used to record all non-identifiable information. The form will be sent via NHS email to Russells Hall Hospital who will collate the data from all sites involved.
- Russells Hall
- North Staffordshire
- New Cross
The surgeon 2013
The pancreatitis group can be contacted at email@example.com.