When is Cholecystectomy Indicated After Acute Pancreatitis?

Acute pancreatitis can be confidently attributed to gallstones when patients have both abnormal liver enzymes and gallstones (or sludge) on imaging; such patients should undergo cholecystectomy to prevent recurrent pancreatitis. Nevertheless, some surgeons recommend cholecystectomy to patients who have normal liver enzymes, normal gallbladder imaging, and no obvious nonsurgical cause of pancreatitis. The premise of cholecystectomy in such cases is that transient test abnormalities or small stones might have been missed — but is that premise correct?

To find out, Mayo Clinic researchers identified 239 patients who underwent cholecystectomy after episodes of acute pancreatitis; patients with medical causes (e.g., alcohol abuse, triglyceridemia…