Laparoscopic cholecystectomy curbs idiopathic pancreatitis

Reuters Health Information: Laparoscopic cholecystectomy curbs idiopathic pancreatitis

Laparoscopic cholecystectomy curbs idiopathic pancreatitis

Last Updated: 2015-11-13

By Reuters Staff

NEW YORK (Reuters Health) - Laparoscopic cholecystectomy can effectively prevent recurrent attacks of idiopathic acute pancreatitis (IAP), according to Finnish researchers.

In the November issue of the Annals of Surgery, Dr. Hannu Paajanen of Kuopio University Hospital and colleagues note that alcohol and gallstones are among the most common etiological factors in acute pancreatitis. However, as many as 30% remain unexplained and are deemed idiopathic.

To determine whether laparoscopic cholecystectomy is effective in such cases, the researchers randomized 39 IAP patients to surgery. A further 46 acted as controls.

Patients were followed for a median of 36 months. During this time significantly more patients in the control group experienced recurrence (14/46 versus 4/39, p=0.016). The number of recurrences was also significantly higher in controls (23/46 versus 8/39, p=0.003).

In the subgroup of patients with at least 24 months' follow-up, the recurrence was even higher among controls (14/37 versus 4/35, p=0.008). This was also the case in patients with normal liver function (13/46 versus 4/39, p=0.026).

Preoperative transabdominal ultrasound was negative in all patients. However, 23 (59%) in the laparoscopic cholecystectomy group showed small stones in their gallbladders during surgery. Results of liver function tests did not differ in patients with or without such stones.

This, say the investigators, supports the view that many idiopathic pancreatitis patients in fact have gallstone etiology despite negative test results.

However, they concluded, "More studies with randomized patients are needed to confirm the results of our trial."

Dr. Paajanen did not respond to requests for comments.

Tampere University Hospital supported this research. The authors reported no disclosures.

SOURCE: http://goo.gl/W4b0Y8

Ann Surg 2015.

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