Patients with mild gallstone pancreatitis can undergo surgery sooner, shortening hospital stays

Patients with mild gallstone pancreatitis usually stay in the hospital for several days, waiting for the symptoms to subside, before undergoing surgery to remedy the condition. A new study from researchers at Los Angeles Biomedical Research Institute (LA BioMed) indicates patients may no longer have to wait so long for surgery and could leave the hospital sooner.

The study, slated for publication in the Annals of Surgery in April, found surgeons could safely operate on patients with mild gallstone pancreatitis within 48 hours of admission, rather than waiting for the painful inflammation in the pancreas to subside before performing the surgery.

“In the study, patients with mild pancreatitis, who underwent surgery within two days of admission, left the hospital sooner and had similar favorable outcomes as those patients who waited several days before surgery,” said Christian de Virgilio, MD, a LA BioMed principal investigator and the corresponding author for the study. “The common practice of delaying surgery on patients with mild gallstone pancreatitis should be abandoned because it results in longer and more costly hospital stays.”

Mild gallstone pancreatitis is caused by a gallstone or gallstones in the common bile duct triggering a backup in the pancreas of the digestive enzymes and hormones it produces to help the body digest food and convert glucose to energy.

The standard treatment is laparoscopic surgery to remove the gall bladder, which produces the gallstones. In the study reported in the Annals of Surgery, surgeons removed the gall bladders of 25 patients with mild gallstone pancreatitis within 48 hours of admission and operated on 24 other patients after lab tests and physical examinations found their enzyme levels had normalized. (One patient was excluded from the study after developing other unrelated medical complications.)

The researchers found operating on the patients within 48 hours of admission decreased the overall length of hospital stays from four to three days when compared with the patients who waited for the symptoms to subside before undergoing surgery.

“Operating within 48 hours of admission is ideally suited to patients with mild gallstone pancreatitis who don't demonstrate evidence of cholangitis, a bacterial infection, and don't require aggressive fluid resuscitation,” said Dr. de Virgilio.

The researchers conducted the study at Harbor-UCLA Medical Center, a Los Angeles County teaching hospital, from November 2007 to November 2008. The study is available for purchase in pre-print format online at http://journals.lww.com/annalsofsurgery/toc/publishahead.

About LA BioMed

Founded in 1952, LA BioMed is one of the country's largest nonprofit independent biomedical research institutes. It conducts biomedical research, educates young scientists and provides community services, including childhood immunization and nutrition assistance. The institute's researchers conduct studies in such areas as cardiovascular disease, emerging infections, cancer, diabetes, kidney disease, dermatology, reproductive health, respiratory disorders and inherited illnesses. LA BioMed is academically affiliated with the David Geffen School of Medicine at UCLA and located on the Harbor-UCLA Medical Center campus.