Abstract
Introduction: Acute pancreatitis is a disease caused by pancreatic enzymes from the inactive form being activated in the pancreas, causing self-destruction of nearby tissues and organs. Gallstones are one of the causes of acute pancreatitis. Acute pancreatitis with mechanical etiology after stable treatment requires radical treatment. ERCP, percutaneous lithotripsy, and surgery are effective treatments. The purpose of this paper is to evaluate the early results of surgical treatment of acute biliary pancreatitis.
Patients and methods: A retrospective review of all patients diagnosed with acute pancreatitis due to gallstones was surgically treated at the Department of Hepatobiliary Surgery of Viet Duc University Hospital from January 2019 to December 2021.
Results: The study group has 49 patients (26 female, 23 male). The mean age at surgery was 56.8 (28-87 years). CT scan identified 100% of pancreatic lesions and gallstones before surgery, of which common bile duct stones accounted for 20.4%, the rest were common bile duct stones combined with gallstones and stones in the liver. One patient was diagnosed with septic shock caused by cholangitis had to be resuscitated before surgery. The surgical intervention on biliary tract was cholecystectomy, stone removal, endoscopic lithotripsy, T tube drainage, combined cholecystectomy and left lobectomy. Open surgery was performed on 35 patients, accounting for 71.4%, and laparoscopic surgery accounted for 28.6%. The intervention on the pancreas was on 8 patients, mainly removing the necrotic pancreatic tissue, draining the lesser sac. Most patients had surgery in the first 2 days, as early as 22 hours, as late as 8 days. There were two patients complicated the surgical site infection, two patients with biliary leak, one patient with acute pancreatitis, all were treated medically. The mean hospital stay was 5.1 days. Laparoscopic surgery gave good results, accounting for 92.9%, there were no severe cases of recurrence or death. 49 patients were followed up 30 days after surgery with a good result (85.7%), no mortality was observed.
Conclusion: Surgical treatment for acute biliary pancreatitis is safe which assesses pancreatic damage, gives good postoperative results.
Keywords: Acute pancreatitis, gallstones, surgery
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