ORIGINAL ARTICLE   

Chirurgia 2023 February;36(1):17-22

DOI: 10.23736/S0394-9508.22.05395-5

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Transient hyperbilirubinemia as a risk factor for gallstones related events of the acute gallstone pancreatitis

Rita M. CAMARNEIRO ¹ ✉, António P. GOMES ¹, Francisco G. CAIRES ², Carolina R. SILVA ², Inês R. CAPUNGE ¹, Ricardo P. ROCHA ¹, Ágata E. FERREIRA ², Vítor M. NUNES ¹

¹ Department of Surgery, Professor Doutor Fernando Fonseca Hospital, Amadora, Portugal; ² Department of Surgery, Centro Hospitalar do Oeste - Hospital das Caldas da Rainha, Caldas da Rainha, Portugal

BACKGROUND: The objective of this paper was to evaluate the risk of recurrent complications of biliary lithiasis, in patients with non-severe acute gallstone pancreatitis (AGP) with cholestasis at presentation. This is a secondary analysis of a prospective maintained database of two centers.
METHODS: Patients with first episode of mild and moderate AGP admitted between January 2014 and December 2017 were included. Demographic variables and standard clinical, radiological, and biochemical parameters were compared among patients according to presence/absence of related gallstone events.
RESULTS: Three hundred ten patients were included. Radiological and biochemical parameters were compared between the group with recurrent gallstone related events and the group with no evidence of recurrence at 1-month, 3-months, 6-months, and 12-months follow-up after the AGP index episode. Total bilirubin (TB) at index AGP admission was higher among patients with subsequent recurrence of gallstone related events. TB of 1.60 mg/dL at admission on index AGP episode was the optimal cut-off point to discriminate between recurrence and no recurrence of gallstone related events.
CONCLUSIONS: These data suggest that AGP patients with cholestasis have a higher rate of recurrence. A surgical priority for cholecystectomy could be stablished in patients with AGP, favoring those with TB in admission greater than 1.6mg/dL.

KEY WORDS: Pancreatitis; Bilirubin; Cholestasis