Frequency of silent gall-stones in acute pancreatitis: A retrospective study at a tertiary care hospital in Peshawar

Abstract

Objective: To evaluate potential association of non-symptomatic gall-stones with the biliary pancreatitis. Introduction: Acute pancreatitis, an infl ammatory condition of the pancreas, is usually mild and self-resolving, without any long-lasting consequences in about 80% of patients. Gall-stone migration leading to duct obstruction causes gall-stone-induced pancreatitis. Th e most common causes of acute pancreatitis are gall-stones and alcohol consumption. Th e incidence of cases of acute pancreatitis has risen globally. It continues to have high rates of morbidity and mortality despite advancements in care, imaging and interventional techniques. Study design: It is an observational cross-sectional, institutional based study. Place and duration of study: Th e study under consideration was conducted in the Surgery Department of Rehman Medical Institute (RMI) Peshawar, from January 2017 to June 2018. Materials & methods: Th ese data was collected from the Department of General Surgery, Rehman Medical Institute. Th e study participants were patients who developed acute pancreatitis. Th e data was analyzed through SPSS version-23 and presented in the form of frequency, percentages and pie charts. Results: From January 2017 to June 2018, a total of 147 patients developed acute pancreatitis, aged 15 to 91 with mean age of 48.5 were admitt ed in the general surgery department of RMI. 49.0% were males and 51.0% were females. During 18 months of study, 147 patients developed acute pancreatitis. 95 patients, 41 (43.1%) male and 54 (56.8%) female developed acute biliary pancreatitis based on the detection of gall stones in the biliary tract by ultrasonography or by endoscopic retrograde cholangiopancreatography (ERCP). Conclusion: Patients with multiple small asymptomatic gall-stones have a greater risk of presenting with acute biliary pancreatitis. Th e decision to intervene should be based on each case individually, taking into the account the age, ultrasound fi ndings, and the signs and symptoms, regardless of how vague they are. Cholecystectomy may be recommended for the patient with microlithiasis. In patients who are poor candidates for surgery, ERCP with biliary sphincterotomy may be a substitutive treatment.