In adults with mild gallstone pancreatitis, cholecystectomy during the same admission lowers the risk of recurrent biliary events compared with interval surgery, and is standard advice in major guidelines. Severe pancreatitis with collections is different: surgery is usually deferred until the inflammation settles. Where same-admission surgery is not possible, ERCP with sphincterotomy offers some protection but does not replace cholecystectomy in fit patients.
- Plan cholecystectomy before discharge for mild gallstone pancreatitis.
- Defer surgery in severe pancreatitis with collections.
- Use ERCP and sphincterotomy as a bridge when surgery must wait.
- Book the operation before discharge if it cannot be done on the index admission.
Why it matters
Delays send patients home to a second attack that was preventable.
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