• Noor J Sissingh, Fleur E M de Rijk, Hester C Timmerhuis, Devica S Umans, AntenMarie-Paule G FMGFDepartment of Gastroenterology and Hepatology, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands., BouwenseStefan A WSAW0000-0002-7600-9429Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands., Foke van Delft, Brechje C van Eijck, Willemien G Erkelens, Wouter L Hazen, Sjoerd D Kuiken, Rutger Quispel, Tessa E H Romkens, Matthijs P Schwartz, Tom C Seerden, SpanierB W MarcelBWMDepartment of Gastroenterology and Hepatology, Rijnstate Hospital, Den Bosch, The Netherlands., Tessa Verlaan, Frank P Vleggaar, Rogier P Voermans, Robert C Verdonk, and Jeanin E van Hooft.
• Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
• Br J Surg. 2024 May 3; 111 (5).

BackgroundData on the incidence and clinical relevance of gallstones in patients with suspected acute alcoholic pancreatitis are lacking and are essential to minimize the risk of recurrent acute pancreatitis. The aim of this study was to assess the incidence of gallstones and the associated rate of recurrent acute pancreatitis in patients with presumed acute alcoholic pancreatitis.MethodsBetween 2008 and 2019, 23 hospitals prospectively enrolled patients with acute pancreatitis. Those diagnosed with their first episode of presumed acute alcoholic pancreatitis were included in this study. The term gallstones was used to describe the presence of cholelithiasis or biliary sludge found during imaging. The primary outcome was pancreatitis recurrence during 3 years of follow-up.ResultsA total of 334 patients were eligible for inclusion, of whom 316 were included in the follow-up analysis. Gallstone evaluation, either during the index admission or during follow-up, was performed for 306 of 334 patients (91.6%). Gallstones were detected in 54 patients (17.6%), with a median time to detection of 6 (interquartile range 0-42) weeks. During follow-up, recurrent acute pancreatitis occurred in 121 of 316 patients (38.3%), with a significantly higher incidence rate for patients with gallstones compared with patients without gallstones (59% versus 34.2% respectively; P < 0.001), while more patients with gallstones had stopped drinking alcohol at the time of their first recurrence (41% versus 24% respectively; P = 0.020). Cholecystectomy was performed for 19 patients with gallstones (36%). The recurrence rate was lower for patients in the cholecystectomy group compared with patients who did receive inadequate treatment or no treatment (5/19 versus 19/34 respectively; P = 0.038).ConclusionGallstones were found in almost one in every five patients diagnosed with acute alcoholic pancreatitis. Gallstones were associated with a higher rate of recurrent pancreatitis, while undergoing cholecystectomy was associated with a reduction in this rate.© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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