BILIARY PANCREATITIS - GOOD INDICATION FOR LAPAROSCOPIC CHOLECYSTECTOMY

Recently the indication for laparoscopic cholecystectomy has been enla rged to include biliary pancreatitis. While a majority of reports reco mmend early open cholecystectomy for biliary pancreatitis the use of l aparoscopic cholecystectomy in this disease has not yet been discussed . We retrospectively reviewed 52 patients with biliary pancreatitis be ing admitted to our ward in the last five years. Cholecystectomy was p erformed in 48 patients. Ten had undergone laparoscopic cholecystectom y. Postoperative complications occurred in 8 of the 48 patients (16.6% ). Four patients (8.3%) died due to necrotizing pancreatitis or ruptur e of pseudocysts. We found a correlation between morbidity and mortali ty and the prognostic score as well as the presence of pseudocysts. We conclude that biliary pancreatitis is a good indication for laparosco pic cholecystectomy in patients with a low prognostic score. The prese nce of pseudocysts in our view is no contraindication for laparoscopy. Although it may increase postoperative morbidity. Choledocholithiasis has to be ruled out either by preoperative ERCP or during laparoscopy with intraoperative cholangiography.