BACKGROUND Two strategies for same-admission cholecystectomy in mild gallstone pancreatitis (MGP) exist: early surgery (within 48-72 h from admission) and delayed surgery until resolution of symptoms and normalization of pancreatic tests. METHODS This was a single-center, open-label RCT. Patients with MGP according to revised Atlanta classification-2012 and SIRS criteria were randomly assigned to early laparoscopic cholecystectomy (E-LC) within 72 h from admission or delayed laparoscopic cholecystectomy (D-LC). Laparoscopic-endoscopic rendezvous was performed when common bile duct stones were found at systematic intraoperative cholangiography. The primary outcome was length of stay (LOS), and the secondary outcomes were complications at 90 days, need for ERCP/choledocolithiasis, conversion, and re-admission. One year of follow-up was carried-on. RESULTS At interim analysis, 52 patients were randomized (26 E-LC, 26 D-LC). E-LC versus D-LC was associated with a significantly shorter LOS (median 58 versus 167 h; P = 0.001). There were no differences in ERCP necessity for choledocolithiasis between the two approaches (E-LC 26.9% versus D-LC 23.1%, P = 1.00). No differences in postoperative complications were found. CONCLUSIONS E-LC approach in patients with MGP significantly reduced LOS and was not associated with clinically relevant postoperative complications. TRIAL REGISTRATION clinicaltrials.gov (NCT02590978).

中文翻译：

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早期腹腔镜胆囊切除术可减少轻度胆结石胰腺炎的住院时间。一项随机对照试验。

背景技术存在两种在轻度胆石性胰腺炎（MGP）中同时入院胆囊切除术的策略：早期手术（入院后48-72小时内）和延迟手术直至症状缓解和胰腺检查正常。方法这是一个单中心，开放标签的RCT。根据入院亚特兰大修订版2012年和SIRS标准的MGP患者在入院或延迟腹腔镜胆囊切除术（D-LC）后72小时内被随机分配到早期腹腔镜胆囊切除术（E-LC）。当在系统的术中胆道造影术中发现胆总管结石时，进行腹腔镜-内窥镜交会。主要结果是住院时间（LOS），次要结果是90天的并发症，需要ERCP /胆囊结石症，转换和再次入院。进行了一年的随访。结果在中期分析中，有52例患者被随机分组​​（26例E-LC，26例D-LC）。E-LC与D-LC的LOS显着缩短（中位值58 vs 167 h； P = 0.001）。两种方法之间胆总管结石的ERCP必要性没有差异（E-LC为26.9％，D-LC为23.1％，P = 1.00）。术后并发症无差异。结论MLC患者采用E-LC方法可显着降低LOS，并且与临床相关的术后并发症无关。试验注册临床试验.gov（NCT02590978）。两种方法之间胆总管结石的ERCP必要性没有差异（E-LC为26.9％，D-LC为23.1％，P = 1.00）。术后并发症无差异。结论MLC患者采用E-LC方法可显着降低LOS，并且与临床相关的术后并发症无关。试验注册临床试验.gov（NCT02590978）。两种方法之间胆总管结石的ERCP必要性没有差异（E-LC为26.9％，D-LC为23.1％，P = 1.00）。术后并发症无差异。结论MLC患者采用E-LC方法可显着降低LOS，并且与临床相关的术后并发症无关。试验注册临床试验.gov（NCT02590978）。