Same‐admission cholecystectomy linked to lower pancreatitis recurrence

Same‐admission cholecystectomy was associated with fewer recurrent episodes of gallstone‐related acute pancreatitis and fewer biliary complications than endoscopic retrograde cholangiopancreatography alone or no intervention in a nationwide Swedish cohort.

By
Andrea Surnit
August 18, 2026
4 min

MDSpire News

Objective:

To evaluate the impact of same-admission cholecystectomy on recurrent pancreatitis and gallstone-related complications in patients with presumed mild gallstone-related acute pancreatitis.

Approach:

Study Design: Analysis of the Swedish Pancreatitis (SwePan) registry involving 9,593 adults hospitalized with a first episode of gallstone-related acute pancreatitis from 2006 to 2019.
Patient Grouping: Patients were grouped based on index-admission management: cholecystectomy with or without ERCP, ERCP alone, or no intervention.
Outcomes Measured: Primary outcome was recurrent acute pancreatitis; secondary outcomes included other gallstone-related complications.
Statistical Analysis: Analyses adjusted for demographic characteristics, socioeconomic factors, comorbidities, and accounted for death as a competing event.

Key Findings:

3% of patients who underwent cholecystectomy experienced recurrent acute pancreatitis compared to 5% with ERCP alone and 18% with no intervention.
Other gallstone-related complications occurred in 2% of cholecystectomy patients, 20% of ERCP patients, and 16% of those with no intervention.
No intervention was associated with a sixfold higher risk of recurrent pancreatitis compared to same-admission cholecystectomy.
ERCP alone showed a modestly higher risk of recurrence primarily within the first 2 weeks post-discharge.
Elective cholecystectomy after discharge led to more recurrent pancreatitis than same-admission cholecystectomy.

Limitations:

Observational design may introduce residual confounding and selection bias.
Patients treated with ERCP alone were generally older and had more comorbidities.
Lack of detailed clinical information on disease severity and other relevant factors.
Exclusion of patients with presumed severe pancreatitis may not fully represent the population.