Can We Prevent the Post-Cholecystectomy Recurrent Pancreatitis?

Laparoscopic Cholecystectomy is an essential part of treatment of so called pancreatitis. It seems a necessary but not sufficient therapeutical act as demonstrated by the biliary still high incidence of post-cholecystectomy pancreatitis. There is no means of knowing which patient affected by biliary pancreatitis with no diagnosable abnormalities of the biliary main tract will develop a recurrent pancreatitis. This study supports the concept that by adding a “clearance” of the biliary tact at the cholecystectomy (so called rendezvous technique), a prevention of recurrent pancreatitis can be obtained. This observational study includes 39 hospitalized patients suffering from an acute biliary pancreatitis episode. None of them had serum bilirubin elevation or jaundice, and 27 had no instrumental evidence of bile duct obstruction while 12 had minor stones in the main bile duct. Rendezvous technique revealed undiagnosed bile duct abnormalities either functional or organic in 13 cases. During a 5 years follow-up period after the procedure no recurrent pancreatitis were observed. Our experience has shown that the technique of Rendezvous can reveal and treat obstructions of the bile duct that have not been diagnosed with instrumental examinations; furthermore, this technique seems to prevent the development of recurrent acute pancreatitis.