Effect Of Operation Timing On Efficacy For Mild Acute Biliary Pancreatitis Patients With Laparoscopic Cholecystectomy

OBJECTIVE To evaluate the efficacy and safety of laparoscopic cholecystectomy for mild acute biliary pancreatitis at different timings,explore the best timing of laparoscopic cholecystectomyMETHODS The clinical date on 115 patients with mild acute biliary pancreatitis who underwent laparoscopic cholecystectomy in the third Affiliated Hospital of Soochow University from July 2016 to February 2018 was reviewed and analyzed retrospectively.According to whether laparoscopic cholecystectomy was performed during the initial admission,patients were divided into early group(89 cases)and delayed group(26 cases).According to the timing of laparoscopic cholecystectomy,patients in early group were divided into group A who accepted laparoscopic cholecystectomy within 3 days of admission,group B who accepted laparoscopic cholecystectomy from4 to 7 days after admission,and group C who accepted laparoscopic cholecystectomy 7 days later.The surgery-related conditions,operation time,intraoperative bleeding,incidence and severity of postoperative complications,incidence of readmission because of recurrent pancreatitis,cholangitis,cholecystitis,common bile duct stones and gallstone colic within 1 year after the initial admission,the total length of hospital stay,and the total cost of hospitalization were compared between different groups.RESULTS Compared with the delayed group,the total hospitalization time in early group was significantly shorter(P<0.01),the total hospitalization cost was significantly less(P<0.01),and the incidence of readmission within one year after the initial admission was lower(P<0.01).The others were not found different in the two groups.In early group,the total length of hospital stay was positively correlated with the timing of surgery(R=0.799),The total hospitalization cost in group C was higher than that in group A and B(P<0.01),The incidence of postoperative complications in group A was higher than groups B and C,but the difference between the three groups was not statistically significant(P=0.078).CONCLUSION It is most beneficial for the patient to accept laparoscopic cholecystectomy during the initial admission when the patients’ symptoms were relieved partly.Because accepting LC at this time did not increase the difficulty of surgery、postoperative complications and the risk of readmission by various reasons,reduce the hospitalization time and hospitalization expense as well.