Trial of the Effect of Timing of Cholecystectomy During Initial Admission for Mild Gallstone Pancreatitis
Trial of the Effect of Timing of Cholecystectomy During Initial Admission for Mild Gallstone Pancreatitis
Randomized trial of laparoscopic cholecystectomy with cholangiogram on admission versus after
 resolution of pain for mild gallstone pancreatitis.
The purpose of this study is to perform a single-center randomized trial to compare
 laparoscopic cholecystectomy with intraoperative cholangiogram (IOC) within 24 hours of
 presentation versus after clinical resolution during index admission for mild gallstone
 pancreatitis on clinical and patient-reported outcomes. Additionally, this study aims to
 determine patients' values and preferences that influence decision-making regarding treatment
 options for gallstone pancreatitis. Hypothesis: During index admission for mild gallstone
 pancreatitis, early cholecystectomy within 24 hours of presentation regardless of symptoms or
 laboratory values versus after clinical resolution results in a shorter 30-day total hospital
 length of stay.
Inclusion Criteria:

 -  Diagnosis of gallstone pancreatitis. Patients will be considered to have gallstone
 pancreatitis if they have:

 1. upper abdominal pain, nausea, vomiting, and epigastric tenderness

 2. absence of ethanol abuse

 3. elevated lipase level above the upper limit of normal (>370 U/L)

 4. imaging confirmation of gallstones or sludge

 -  Low predicted mortality using the Bedside Index of Severity in Acute Pancreatitis
 (BISAP) -Diagnosis of mild pancreatitis (i.e.,no evidence of organ failure or local or
 systemic complications)

 -  Scheduled for laparoscopic cholecystectomy prior to discharge

 -  Lack of any very strong indicator for choledocholithiasis based on the American
 Society for Gastrointestinal Endoscopy (ASGE) guidelines

 -  Clinical stability as denoted by admission to a non-monitored floor bed.

 Exclusion criteria

 -  Pregnancy

 -  Severe preexisting medical comorbidities precluding surgery, organ failure, local or
 systemic complications of acute pancreatitis

 -  Chronic pancreatitis

 -  Native language other than English and Spanish

 -  Patient refusal to participate