Gallstone pancreatitis. The question of time

J. M. Burch, D. V. Feliciano, K. L. Mattox and G. L. Jordan Jr
Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, TX 77030.

Two hundred consecutive patients with gallstone pancreatitis were treated during a 6-year period; 92 patients were operated on after the acute attack subsided but during the same admission (group 1), 102 patients were discharged after recovery and scheduled for elective surgery (group 2), and the conditions of 6 patients deteriorated and they underwent emergency operation (group 3). All patients in group 3 had hemorrhagic pancreatitis. Mortalities for groups 1, 2, and 3 were 0%, 0%, and 50%, respectively. Although the outcome of patients in groups 1 and 2 was similar, only 60 of 102 patients in group 2 had their treatment completed. Furthermore, 29 (44%) of 65 patients who were followed up in group 2 suffered recurrent pancreatitis or biliary tract disease before elective surgery. The timing of surgery in patients whose conditions improve is not critical; however, patients whose conditions deteriorate after admission have severe disease with high morbidity and mortality.