The impact of timing of cholecystectomy following gallstone pancreatitis

Marianne Johnstone, Paul Marriott, T James Royle, Caroline E Richardson, Andrew Torrance, Elizabeth Hepburn, Aneel Bhangu, Abhilasha Patel, David C Bartlett, Thomas Pinkney, Gallstone Pancreatitis Study Group

Research output: Contribution to journalArticlepeer-review

33 Citations (Scopus)


INTRODUCTION: Current guidelines for the management of acute gallstone pancreatitis recommend cholecystectomy as definitive treatment during primary admission or within 2 weeks of discharge, with the aim of preventing recurrent pancreatitis. However, cholecystectomy during the inflammatory phase may increase surgical complication rates. This study aimed to determine whether adherence to the guidelines prevents recurrent pancreatitis while minimising surgical complications.

METHODS: Multi-centre review of seven UK hospitals, indentifying patients presenting with their first episode of gallstone pancreatitis between 2006 and 2008.

RESULTS: A total of 523 patients with gallstone pancreatitis were identified, of which 363 (69%) underwent cholecystectomy (72 during the primary admission or within 2 weeks of discharge; 291 following this). Overall, 7% of patients had a complication related to cholecystectomy of which a greater proportion occurred when cholecystectomy was performed within guideline parameters (13% vs 6%; p = 0.07). 11% of patients were readmitted with recurrent pancreatitis prior to surgery, with those undergoing cholecystectomy outside guideline parameters being most at risk (p = 0.006).

CONCLUSION: This study suggests cholecystectomy within guideline parameters significantly reduces recurrence of pancreatitis but may increase the risk of surgical complications. A prospective randomised study to assess the associated morbidity is required to inform future guidelines.

Original languageEnglish
Pages (from-to)134-40
Number of pages7
Issue number3
Early online date7 Nov 2013
Publication statusPublished - Jun 2014


  • Adult
  • Aged
  • Aged, 80 and over
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholecystectomy
  • Female
  • Follow-Up Studies
  • Gallstones
  • Guideline Adherence
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Pancreatitis
  • Pilot Projects
  • Recurrence
  • Retrospective Studies
  • Journal Article
  • Multicenter Study
  • Gallstone pancreatitis
  • BSG guidelines
  • ERCP


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