Abstract:

INTRODUCTION: Early or at the same hospitalization laparoscopic cholecystectomy (LC) is recommended for acute calculous cholecystitis and biliary pancreatitis. Interval cholecystectomy is planned for patients who cannot undergo early or in same hospitalization cholecystectomy. We examined the role of pre-operative magnetic resonance cholangiopancreatography (MRCP) in interval LC. METHODS: Twenty-three patients aged between 45 and 70, who underwent interval LC after biliary pancreatitis or acute cholecystitis, had no history of endoscopic retrograde cholangiopancreatography, had no abnormality in laboratory tests and underwent pre-operative MRCP in our hospital between April–June 2022, were retrospectively analyzed. Patients who did not have recurrent biliary pancreatitis/acute cholecystitis/cholangitis attacks during the waiting period but who admitted to the hospital with mild complaints such as biliary colic-nausea or asymptomatic patients were included. RESULTS: Fourteen patients were female and nine patients were male, mean age was 62.5 years. Thirteen patients had a history of acute cholecystitis and ten patients had a history of biliary pancreatitis. During the waiting period, five patients after acute cholecystitis and four patients after biliary pancreatitis received symptomatic treatment. All patients underwent pre-operative MRCP. Choledocholithiasis was detected in pre-operative MRCP in two patients with a history of acute cholecystitis and in three patients with a history of biliary pancreatitis. It was found that three out of five patients with choledocholithiasis received symptomatic treatment in the emergency department with mild complaints. Cystic duct anatomical variation was detected in six different patients. DISCUSSION AND CONCLUSION: MRCP can reduce the incidence of LC complications and conversion rates. Pre-operative use of MRCP is controversial and criteria are needed for its indication. Interval cholecystectomy and biliary colic may be among them.

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