Evaluating the Timing of Cholecystectomy in Gallstone-Induced Pancreatitis: Adherence to Guidelines and Impact on Patient Outcomes

TL;DR

This study examines if following guidelines for early cholecystectomy in gallstone pancreatitis improves patient outcomes and reduces readmissions.

Contribution

The study evaluates real-world adherence to early cholecystectomy guidelines and its impact on recurrence and readmission rates.

Findings

Adherence to guidelines increased timely cholecystectomies from 32% to 53%.

Non-surgical patients had a 40% to 29% reduction in recurring admissions.

Early cholecystectomy is associated with lower recurrence risk.

Abstract

Background

To avoid recurrence, patients with mild to moderate gallstone-induced pancreatitis should have a cholecystectomy as soon as possible. The aim of this study was to ascertain if adherence to surgical time recommendations influences patient outcomes, especially regarding readmission rates.

Methodology

We performed a retrospective study of patients admitted between September 2024 and July 2025 with gallstone pancreatitis at Dr. Hassan Ghazzawi Hospital, Jeddah, Saudi Arabia. Comparing those treated before and after the implementation of guideline recommendations for early cholecystectomy. Demographic information, the number of admissions, and the timing of the operation were obtained from hospital records. Patients were divided into four categories: timely (index admission), moderately delayed (weeks), significantly delayed (months/years), and non-surgical. Continuous variables were summarized as means and standard deviations, whereas categorical variables were displayed as frequencies and percentages. The groups have been compared using Fisher's exact test as well as the Chi-square test. A p-value of <0.05 has been considered statistically significant.

Result

The study covered 47 surgical patients and 47 non-surgical patients. Following guideline adoption, the proportion of timely cholecystectomies increased (32% vs. 53%), while significantly delayed procedures dropped (39% vs. 7%), although this trend did not achieve statistical significance (p = 0.075). The rate of multiple admissions was not statistically different (19% vs. 13%, p = 1.0). In the non-surgical sample, the mean number of admissions reduced (1.57 to 1.41) while recurring admissions (>1) fell (40% to 29%). The mean patient age was similar between groups (57 and 58 years).

Conclusion

Guideline adherence improved surgical timing and decreased recurrence of gallstone pancreatitis. Early cholecystectomy, preferably during the initial admission, should be the standard of care. Non-surgical patients remain at increased risk of readmission and require regular monitoring.