Objective: The objective is to determine the adequacy of early cholecystectomy (EC) versus interval cholecystectomy (IC) in terms of recurrence, duration of hospital admission, and perioperative complications after mild acute biliary pancreatitis (MABP). Methodology: After endorsement from the ethical committee, clinical data and files of all the admitted patients having MABP in the general surgery department of Holy Family Hospital, Rawalpindi, was collected retrospectively from August 2017 to July 2020. The patients’ demographic profile, clinical findings, diagnostic investigations, timing of cholecystectomy, operating surgeons, operative time, biliary complications, intraoperative bleeding, conversion rate, duration of admission, and recurrence were reviewed. Patients presented with abdominal pain, vomiting, jaundice, or fever. The diagnosis was confirmed on the basis of a CT scan of the abdomen showing an inflamed pancreas and stones in the gallbladder. Outcomes were compared and reviewed between the two groups. Results: In this research proposal, 263 patients admitted were analyzed. EC was performed were discharged after conservative management and followed up after 12 weeks for interval laparoscopic cholecystectomy (IC). It was observed in patients of IC (EC 2 [1.2%] vs IC 7[7%]; p value <0.01) while duration of hospitalization was prolonged as compared to patients of EC (EC 5.53+0.58days vs IC 5.82+0.78days; p value <0.001). lar in both EC and IC. Conclusion: EC performed after MABP is associated with shorter duration of hospitalization and reduced recurrence with similar rate of perioperative complications.

Aim Dietary and many other factors have been shown to increase the risk of gallstones, but their association with stone type is poorly understood. This study aims to assess the association of dietary and obstetric factors with the type of gallstone. Method 116 consecutive patients requiring cholecystectomy due to gallstone disease, admitted in our hospital, from January 2019 to December 2020 were included in this study. Demographic details, medical history, lifestyle and dietary habits, obstetric history and laboratory parameters were recorded using a data collection form developed by the researchers. Removed gallstones were classified as being cholesterol or pigment by gross visual inspection. Results Cholesterol gallstones were found in 76 (65.5%) and pigment stones in 40 (34.5%) of 116 total patients. Drug use was significantly higher in pigment stone group as compared to cholesterol group (p=0.002). Patients with cholesterol stones consumed significantly higher beef, fish and confectionery items than patients with pigment stones with a p-value of 0.043, 0.017 and 0.041, respectively. Parity was significantly higher in patients with pigment stones as compared to patients with cholesterol stones (p=0.023). A logistic regression model to assess the effect of beef, fish and confectionery item consumption and age at first pregnancy with the likelihood of having cholesterol gallstone was statistically significant (p=0.017) and showed that risk is higher in patients with age ≤ 20 years at first pregnancy [OR 6.89 (95% CI 1.24–38.15), p=0.027]. Conclusions This study concludes that diet and obstetric factors can influence the type of gallstone.

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