Early versus delayed laparoscopic cholecystectomy for acute mild biliary pancreatitis: a prospective comparative study

Introduction: Acute mild biliary pancreatitis accounts for 80-90% of the cases of biliary pancreatitis with laparoscopic cholecystectomy being the gold standard of treatment. The aim of this study was to evaluate the outcomes of early versus delayed cholecystectomy following mild biliary pancreatitis in Nepalese patients. Materials and Methods: This was a hospital-based prospective observational study where 38 patients were divided into two groups: an early cholecystectomy group (n = 19) or a delayed cholecystectomy group (n = 19). The primary outcome measure was the length of hospital stay, while secondary outcomes included recurrent biliary events, duration of surgery, conversion rate to open cholecystectomy, and perioperative complications. Results: The study groups were similar in terms of demographics, comorbidities, and disease severity. The mean duration of hospital stay was significantly shorter in the early group (5.42 +/- 1.01 days) compared to the delayed group (9.36 +/- 1.53 days) (P < 0.05). Additionally, a higher proportion of patients in the delayed group (26.32%) experienced recurrent episodes of biliary colic, whereas none did in the early group (P < 0.05). No statistically significant differences were observed in terms of duration of surgery, conversion to open cholecystectomy, intraoperative complications, or postoperative complications between the two groups. Conclusion: In cases of acute mild biliary pancreatitis, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without increasing operative difficulty or perioperative morbidity.