[Effect of the date of surgery on the prognosis of severe acute biliary pancreatitis. Associations of Surgery Research]. / Influence de la date de l'intervention chirurgicale sur le pronostic des pancréatites aiguës biliaires graves. Associations de recherche en chirurgie.

AIM OF THE STUDY: Among 234 patients included in a prospective, multicentric study on severe acute pancreatitis, 70 patients presented severe cases of acute biliary pancreatitis. The charts of these patients were reviewed in order to evaluate the influence of biliary surgery timing on the outcome. PATIENTS AND METHODS: Operations were performed on sixty-two patients. Patients were divided into three groups according to the timing of the operation. Patients in group 1 (n = 35) were operated on during the first week after the onset of acute pancreatitis; patients in group 2 (n = 16) between 7 and 20 days; and patients in group 3 (n = 11) after 20 days. Severity of the disease, assessed by the bioclinical and CT scan scores of Ranson, was not different in the three groups. RESULTS: There was no statistical difference between the groups regarding complications and mortality rates, although patients operated on early had a higher rate of complications and mortality. CONCLUSION: This study confirms that early biliary surgery worsens the prognosis in severe acute biliary pancreatitis, without statistical proof.