Context: Recently published management guidelines for acute pancreatitis provide a standard against which practice can be measured. Specifically it is recommended all patients with gallstone induced pancreatitis have definitive clearance of gallstones within four weeks.
Objective: To determine if practice in our institution followed these guidelines and to analyse the effects of delayed clearance of gallstones.
Methods: Seventy-six consecutive patients with gallstone pancreatitis presenting within a 15 month period were prospectively studied to compare management with national guidelines and to determine rates of recurrent biliary-pancreatic disease due to delay in clearance of gallstones.
Results: Only 5 of 76 patients (6.6%) had operative removal of gallstones within four weeks of their episode of acute pancreatitis. Only 34 of 76 patients (44.7%) had their gallstones removed during the follow up period (minimum 8 months). Fourteen of 76 patients (18.4%) had unplanned readmissions to hospital with biliary-pancreatic disease, necessitating a total of 135 days in hospital.
Conclusions: It is clear from this study that guidelines for the management of gallstone acute pancreatitis are not being met, resulting in high rates of readmission with related disease.