[Acute gallstone pancreatitis--when should the clearance of biliary tract be performed?].

BACKGROUND

On the basis of a 19-year material we discuss early or delayed surgery for definitive clearance of the biliary tract after acute gallstone pancreatitis.

MATERIAL AND METHODS

During 1980-98, 218 patients, 133 women and 85 men, median age 69.5 years (16-96 years) with acute gallstone pancreatitis were treated at Levanger hospital, Norway. During 1980-89 (period 1), 111 patients were mainly treated by open operations as soon as the acute pancreatitis had settled, while during 1990-98 (period 2), 107 patients were mainly treated conservatively and the biliary operations performed laparoscopically/endoscopically later.

RESULTS

In period 1 two patients died, one of them after open surgery (2%). In period 2 four patients died. 21 patients were readmitted due to a new attack, two of whom died. Two patients developed acute cholecystitis.

INTERPRETATION

Early surgery for the gallstone disease in patients with acute gallstone pancreatitis is well tolerated, recurrent attacks are rare and the mortality low.