1. The Value of Performing Early Non-enhanced CT in Developing Strategies for Treating Acute Gallstone Pancreatitis
- Author
-
Jie Zhang, Bing-cang Huang, Tao-ying Qi, Jin Li, Jiang-Qi Liu, Rong-long Xia, Neng-ping Li, Ya-yun Zhang, Jing Xu, and Jiang-nan Dong
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Enhanced ct ,Biliary obstructions ,Computed tomography ,Gallstones ,030230 surgery ,Sensitivity and Specificity ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Young adult ,Prospective cohort study ,Aged ,Aged, 80 and over ,Common bile duct ,medicine.diagnostic_test ,business.industry ,Length of Stay ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Pancreatitis ,Acute Disease ,Female ,030211 gastroenterology & hepatology ,Surgery ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
The purpose of this study is to assess the value of early abdominal non-enhanced computed tomography (NECT) in developing strategies for treating acute gallstone pancreatitis (AGP). AGP patients underwent NECT within 48 h after symptom onset to determine the presence of peripancreatic fluid collection, gallstones, and common bile duct stones. Patients with mild AGP who had neither organ failure by clinical data nor peripancreatic fluid collection by NECT (classified as grade A, B, or C based on the Balthazar CT grading system) were randomized to undergo an early laparoscopic cholecystomy (ELC; LC performed within 7 days after a pancreatitis attack, without waiting for symptom resolution) or late laparoscopic cholecystomy (LLC; LC performed ≥ 7 days following an attack, with the patient being completely free of AGP symptoms). The study enrolled 102 patients with mild AGP defined by clinical data and NECT. NECT was 89.2 % and 87.8 % accurate in detecting gallbladder stones and CBD stones, respectively. Totals of 49 and 53 patients were assigned to an ELC and LLC group, respectively. All patients in both groups were cured, no LC-related complications occurred, and no case of AGP increased in severity following LC. The mean lengths of hospital stay and LC operation time were significantly shorter in the ELC group than the LLC group (P
- Published
- 2016
- Full Text
- View/download PDF