International Surgery Journal | February 2024 | Vol 11 | Issue 2 Page 284 International Surgery Journal Vagholkar K et al. Int Surg J. 2024 Feb;11(2):284-286 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Case Report Post-laparoscopic cholecystectomy pancreatitis Ketan Vagholkar*, Suvarna Vagholkar, Tanay Purandare INTRODUCTION Laparoscopic cholecystectomy is one of the commonest operations performed on the biliary tract. Multitude of complications may develop depending upon the difficulty of situation caused by inflammation and adhesions during the course of surgery. Majority of these are related to the biliary system. Acute pancreatitis following laparoscopic cholecystectomy is an extremely rare complication. 1 What causes acute pancreatitis in such a setting continues to be a debatable issue. A case of acute pancreatitis in a 37-year-old lady who had undergone laparoscopic cholecystectomy is presented to create awareness of this complication as well as to outline further surgical care in such cases. CASE REPORT A 37-year-old lady with established diagnosis of uncomplicated gall stones presented for evaluation. On general examination there was no icterus or pallor. Physical examination of the abdomen did not reveal any abnormality. LFT and CBC were within normal limits. USG of the abdomen revealed multiple gall stones. No evidence of gall bladder wall thickening or CBD dilatation or stones. Patient underwent Lap-chole. Intra- operatively, it was revealed to be a normal CBD with a patent cystic duct (Figure 1). Intraoperative and post- operative course was uneventful event. Patient presented 3 weeks after discharge with severe excruciating pain in the upper abdomen. On examination, the patient was Icteric, pulse was 110 beats/min and the blood pressure were 110/70 mmHg. Per abdomen examination revealed rebound tenderness and guarding in the epigastrium, CBC showed a total count 11,790. Total bilirubin-4 mg/dl with a direct bilirubin of 2.8 mg/dl whereas SGPT and SGOT were normal. Serum lipase was 2387 IU/l and serum amylase was 5398 IU/l. ABSTRACT Laparoscopic cholecystectomy is one of the commonest operations performed on the biliary system. Acute pancreatitis following Lap-chole is quite uncommon. Whether pancreatitis is a complication or a sequalae to surgical treatment of gall stone disease continues to be a debatable issue. A 37-year-old lady underwent laparoscopic cholecystectomy for incidentally diagnosed gall stones. Early post-operative course was uneventful. The patient presented 3 weeks after surgery with severe excruciating abdominal pain and was diagnosed as acute pancreatitis by ultrasound evaluation. Liver function tests were altered with raised bilirubin, serum lipase and amylase. MRCP revealed a normal biliary tract. Pancreas showed changes of acute interstitial pancreatitis. Patient responded to conservative line of treatment. Acute pancreatitis could be a known complication following laparoscopic cholecystectomy. What causes pancreatitis continues to be a matter for debate. MRCP is the investigation of choice. Interventional endoscopy (ERCP) is indicated in cases of impacted gallstone in the CBD. While if the CBD is clear of stones, aggressive conservative management will suffice. Keywords: Post laparoscopic, Cholecystectomy, Pancreatitis, Treatment Department of General Surgery, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India Received: 27 November 2023 Accepted: 26 December 2023 *Correspondence: Dr. Ketan Vagholkar, E-mail: kvagholkar@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2349-2902.isj20234164