الفهرس | Only 14 pages are availabe for public view |
Abstract In this study, the data of (40)patients with mild acute Biliary Pancreatitis who presented for the first time to the Department of General Surgery at Ain Shams University Hospitals, Cairo, Egypt., were collected during the period of december 2020 to july 2021. The diagnosis of acute Biliary Pancreatitis was based on acute abdominal pain, tenderness, amylase, and lipase levels increased by up to three times the normal limit, and detection of gallstones on ultrasonography. Presentation of increased gallbladder wall thickness and computed tomography CT abdomen. The following parameters were evaluated: age, sex, current illness, medical history, vital signs, laboratory results { cbc, liver function, serum amylase}. Patients were treated with adequate fluid resuscitation and analgesics and antibiotics. Severity of acute pancreatitis was assessed using the Revised Atlanta Criteria at the first hospitalization in both groups. The patients age ranged from 25 To 60 years. They were devided into 2 groups the 1st group (A) composed of 20 patients (4 males and 16 females) group(B) formed of 20 patients (4 males and 16 females). Some patients showed complication of pancreatitis (pancreatic oedema, pseudocyst, ascites).All patents of group (A) did LC within one week of first attack of pancreatitis. All patents of group (B) did LC with in duration of 6 weeks of first attack of Acute Biliary Pancreatitis. Preoperatively, third-generation cephalosporin was administered intravenously within 1 hour of the incision time in all patients. The same laparoscopic surgical techniques were used in all operations, in laparoscopic surgery with insufflation of the abdominal cavity at 12 to 15 mmHg. Following discharge, patient follow-up was conducted in the outpatient clinic or by the referring surgeon. The current study found that of recurrence Biliary Pancreatitis is more in patients who did late cholecystectomy than patients who did early cholecystectomy. no significant difference in bleeding in both groups.. Adhesions are more in patients who did late cholecystectomy than patients who did early cholecystectomy but non significant. Patients who did late cholecystectomy have more Post-operative wound infection than patients who did early cholecystectomy but non significant. no significant difference in biliary complication (biliary injury, Biliary leak or missed stone. Post-operative pain is more in patients who did late cholecystectomy than patients who did early cholecystectomy but non significant. the hospital stay is more in patients who did late cholecystectomy than patients who did early cholecystectomy. |