Optimal Timing and Outcomes of Minimally Invasive Approach in Acute Biliary Pancreatitis

Background: We analyzed the outcomes of early biliary decompression by a minimally invasive approach in acute biliary pancreatitis (ABP). Material/Method: A retrospective study was conducted on 143 patients with ABP who underwent biliary decompression by lap-aroscopic or endoscopic approach between January 2015 and March 2022. Data from the observation sheets and surgical protocols were analyzed in terms of demographic characteristics, clinical and paraclinical features at admission, comorbidities, therapeutic management, and outcomes. Results: The mean patient age was 62.3 +/- 11.4 years. Mild ABP had a higher frequency in men (75.5%) and urban ar-eas (70.4%). The comorbidities associated with a higher risk of severe forms were diabetes mellitus (odds ra-tio [OR]: 11.250), chronic bronchopneumopathy (OR: 29.297), and ischemic coronary disease (OR: 2.784). The mean hospital stay was 7.6 +/- 3.8 days and was significantly higher in severe forms (10 +/- 2.4 days, P<0.001). The time from onset to presentation was significantly higher in severe vs mild forms (5.6 vs 1.8 days, P<0.001) and was associated with systemic and local complications. Creatinine over 2 mg/dL (OR: 4.821) and leukocytes >15 000/mmc at admission (OR: 3.533) were risk factors for systemic complications, while obesity was asso-ciated with increased local complications (OR: 5.179). None of the patients with an early presentation devel-oped severe ABP. Conclusions: Early biliary decompression, as soon as possible after onset, either by an endoscopic or minimally invasive ap-proach, is a safe and effective procedure in ABP. The type of procedure and optimal timing should be individ-ualized, according to the patient's local and general features.

Automated summary

This study analyzed the outcomes of early biliary decompression in acute biliary pancreatitis. The results showed that early biliary decompression, either by endoscopic or minimally invasive approach, is a safe and effective procedure in treating acute biliary pancreatitis. The timing of the procedure should be individualized based on the patient's characteristics.