Journal of Gastrointestinal Surgery

, Volume 12, Issue 12, pp 2164–2170 | Cite as

Timing of Cholecystectomy for Biliary Pancreatitis: Do the Data Support Current Guidelines?

  • Kaori Ito
  • Hiromichi Ito
  • Edward E. Whang
original article



Current guidelines suggest that cholecystectomy be performed within 2 weeks after discharge following an episode of biliary pancreatitis. We hypothesized that a high incidence of gallstone-related events is present within 2 weeks after discharge prior to cholecystectomy.


Two hundred eighty-one patients who underwent cholecystectomy for biliary pancreatitis (January 1999–December 2005) were categorized into one of two groups: group A patients underwent cholecystectomy during index admission (n = 162), and group B patients underwent cholecystectomy following discharge from index admission (n = 119).


Groups were comparable in demographics, comorbidities, and disease severity. Thirty-nine (32.8%) group B patients experienced pre-cholecystectomy gallstone-related events (including 16 cases of recurrent pancreatitis) after discharge. Recurrences (31.3%) occurred within 2 weeks after discharge. Endoscopic sphincterotomy protected against preoperative recurrent pancreatitis but was associated with a higher incidence of other gallstone-related events. Median total length of hospital stay was greater for group B than for group A [7 (range, 2–37) days vs. 5 (1–45) days, respectively, p = 0.00].


Current guidelines suggesting the appropriateness of waiting up to 2 weeks for cholecystectomy for biliary pancreatitis may place patients at unacceptably high risk for recurrence. Endoscopic sphincterotomy does not eliminate the risk of gallstone-related events.


Biliary pancreatitis Cholecystectomy Recurrent pancreatitis Endoscopic sphincterotomy 



endoscopic sphincterotomy


length of hospital stay


computed tomography


endoscopic retrograde cholangiopancreatography



The authors thank to Jan Rounds for her excellent secretarial assistance.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2008

Authors and Affiliations

  1. 1.Department of Surgery, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA

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