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July 1991

Biliary Pancreatitis: Operative Outcome With a Selective Approach

Author Affiliations

From the Department of Surgery, University of Texas Health Science Center (UTHSC) at San Antonio and Audie L. Murphy Memorial Veterans Hospital, San Antonio, Tex.

Arch Surg. 1991;126(7):836-840. doi:10.1001/archsurg.1991.01410310046006

• To evaluate the efficacy of a selective approach to biliary pancreatitis, we reviewed the outcomes in 276 consecutive patients undergoing operations for this diagnosis during a 7-year period. Initial conservative therapy resulted in elective operations in 63% and urgent operations in 37%. Only 10 patients (3.6%) required primary pancreatic operations, 50% of them as emergencies. The proportion of common duct surgical explorations fell from 70% of those operated immediately after hospital admission to 20% by the third hospital day. Overall mortality was 1.8% but was increased to 30% in patients having an initial pancreatic operation. We conclude that a selective approach to biliary pancreatitis allows the operation to be performed electively in most patients and is associated with a low mortality and an acceptable length of stay. Most common duct stones pass spontaneously permitting cholecystectomy alone.

(Arch Surg. 1991;126:836-840)

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