الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Acute biliary pancreatitis and timing of cholecystectomy has always been a challenge for surgeons, both the diagnosis and treatment have changed over last years with the introduction and application of advanced imaging modalities as well as endoscopic and laparoscopic techniques.
This study was carried out on twenty patients with acute biliary pancreatitis. The aim of the study is aims to evaluate the outcome of early laparoscopic cholecystectomy after acute mild biliary pancreatitis on same admission before discharge, “advantage and disadvantages”.
There were fourteen females (70%) and six males (30%), their age ranged from 22 to 75 years with mean age of 42 + 16.62 years. All cases are subjected to through history taking and complete clinical examination. Laboratory investigations (aspartate aminotransferase, alanine aminotransferase, total and direct bilirubin, alkaline phosphatase, white blood cell count, serum amylase and lipase) followed by ultrasonography, computed tomography (CT) and magnetic resonance cholangiopancreatecography (MRCP) when needed, were then performed.
Abdominal pain was the presenting symptom in all patients (100%), jaundice was present in 12 cases (60%), cholangitis in 2 cases (10%), and history of previous attack of pancreatitis in 2 cases (10%).
Ultrasonography showed gallstones in all cases and bulky pancreas in 14 cases (70%), CT was diagnostic in all cases and used for scoring of pancreatitis, MRCP was used in 4 cases (20%) to evaluate the dilation of CBD and exclusion of stones.
Patients with mild biliary pancreatitis were included. Patients with complicated pancreatitis, severe pancreatitis or unfit for laparoscopic surgery were excluded.
Patients were subjected to laparoscopic cholecystectomy (LC) and intraoperative cholangiography when indicated. In sixteen cases (80%) LC was done only, and in four cases (20%) ductal evaluation was done using laparoscopic IOC.
MRCP was done in these 4 cases (20%), and revealed CBD multiple small gallstones. IOC was done and shown:
Two cases (10%) CBD was already free and the other two cases (10%) there is small stones found so CBD stone extraction needed through trans cystic CBD exploration with IOC.
The mean operative time for laparoscopic cholecystectomy was 53+ 12.61 minutes (median 52.5 minutes, range from 30-75 minutes).
The mean hospital stay was 1.8+1.2 days (ranged from 1-4 days).
Peristalsis was audible and patients started oral fluid intake in the same day of surgery in 18 cases (90%), oral fluid intake started on the first postoperative day in 2 cases (10%). The tube drain was removed after 24 hours in 12 cases (60%), in 4 cases after 48 hours and in four cases after 72 hours.
There was no 30 days’ mortality.