(Journal Article): Management of Gallstone Pancreatitis: Effects of Deviation from Clinical Guidelines
 
Sargen K, Kingsnorth AN (Department of Surgery, Plymouth Postgraduate Medical School, Derriford Hospital. Plymouth. United Kingdom, andrew.kingsnorth@phnt.swest.nhs.uk )
 
IN: JOP. J Pancreas (Online) 2001; 02(5):317-322

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ABSTRACT: CONTEXT: Recently published management guidelines for acute pancreatitis provide a standard against which practice can be measured. Specifically it is recommended all patients with gallstone induced pancreatitis have definitive clearance of gallstones within four weeks. OBJECTIVE: To determine if practice in our institution followed these guidelines and to analyse the effects of delayed clearance of gallstones. METHODS: Seventy-six consecutive patients with gallstone pancreatitis presenting within a 15 month period were prospectively studied to compare management with national guidelines and to determine rates of recurrent biliary-pancreatic disease due to delay in clearance of gallstones. RESULTS: Only 5 of 76 patients (6.6%) had operative removal of gallstones within four weeks of their episode of acute pancreatitis. Only 34 of 76 patients (44.7%) had their gallstones removed during the follow up period (minimum 8 months). Fourteen of 76 patients (18.4%) had unplanned readmissions to hospital with biliary-pancreatic disease, necessitating a total of 135 days in hospital. CONCLUSIONS: It is clear from this study that guidelines for the management of gallstone acute pancreatitis are not being met, resulting in high rates of readmission with related disease.

TYPE OF PUBLICATION: Original Article