Comparison of Outcomes Between Early and Delayed Cholecystectomy in Acute Biliary Pancreatitis Patients

Abstract

Objective: To compare the outcomes of early versus delayed cholecystectomy in patients with ABP to guide clinical decision-making. 
Study Design: Prospective comparative study 
Place and Duration of Study: This study was conducted at the Department of General Surgery, Lady Reading Hospital, Peshawar, from August 2022 to February 2023. 
Methods: A total of 120 patients were included, divided into two groups: early cholecystectomy (n=60) and delayed cholecystectomy (n=60). Data on demographics, clinical outcomes, and complications were collected and analyzed using SPSS version 26. 
Results: The groups were comparable in baseline characteristics. ‘The early cholecystectomy group had a significantly shorter hospital stay’ (5.09 ± 0.90 vs. 8.89 ± 1.79 days; p<0.001). ICU admissions were higher in the early group (81.7% vs. 43.3%; p<0.001), but mortality and recurrence rates were similar between groups. Postoperative complications, bile leaks (71.7% vs. 46.7%; p=0.005), and surgical site infections (65.0% vs. 33.3%; p=0.001) were more common in the early group. 
Conclusion: Early cholecystectomy reduces hospital stay and prevents recurrent pancreatitis but is associated with higher postoperative complications. Careful patient selection and perioperative management are essential. Delayed cholecystectomy remains an option for patients with severe inflammation or high surgical risk. These findings contribute to optimizing ABP management strategies.