21 June 2022 : Clinical Research1CDFG, Claudia Diana Gherman3ACF, Ciprian Ionut Bacila1CDFG, Denisa Tanasescu4BCEF, Dragos Serban 56CDF, Laura Carina Tribus78CDF, Corneliu Tudor 6DEF, Gabriel Catalin Smarandache96CDF, Daniel Ovidiu Costea1011CEF, Mihail Silviu Tudosie1213CEF, Dan Sabau12ABCF, Gabriel Andrei Gangura914DEF, Ciprian Tanasescu12ABCF
Med Sci Monit In Press; DOI: 10.12659/MSM.937016
Available online: 2022-06-21, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
We analyzed the outcomes of early biliary decompression by a minimally invasive approach in acute biliary pancreatitis (ABP).
MATERIAL AND METHODS
A retrospective study was conducted on 143 patients with ABP who underwent biliary decompression by laparoscopic or endoscopic approach between January 2015 and March 2022. Data from the observation sheets and surgical protocols were analyzed in terms of demographic characteristics, clinical and paraclinical features at admission, comorbidities, therapeutic management, and outcomes.
The mean patient age was 62.3±11.4 years. Mild ABP had a higher frequency in men (75.5%) and urban areas (70.4%). The comorbidities associated with a higher risk of severe forms were diabetes mellitus (odds ratio [OR]: 11.250), chronic bronchopneumopathy (OR: 29.297), and ischemic coronary disease (OR: 2.784). The mean hospital stay was 7.6±3.8 days and was significantly higher in severe forms (10±2.4 days, P<0.001). The time from onset to presentation was significantly higher in severe vs mild forms (5.6 vs 1.8 days, P<0.001) and was associated with systemic and local complications. Creatinine over 2 mg/dL (OR: 4.821) and leukocytes >15 000/mmc at admission (OR: 3.533) were risk factors for systemic complications, while obesity was associated with increased local complications (OR: 5.179). None of the patients with an early presentation developed severe ABP.
Early biliary decompression, as soon as possible after onset, either by an endoscopic or minimally invasive approach, is a safe and effective procedure in ABP. The type of procedure and optimal timing should be individualized, according to the patient’s local and general features.
Keywords: Biliary Tract Surgical Procedures; Laparoscopy; Pancreatitis
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