{"id":31234,"date":"2026-10-02T04:44:00","date_gmt":"2026-10-01T20:44:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=31234"},"modified":"2026-10-02T05:57:54","modified_gmt":"2026-10-01T21:57:54","slug":"jama-surg%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%83%86%e5%9b%8a%e5%88%87%e9%99%a4%e6%9c%af%e4%b8%8eercp%e6%88%96%e6%97%a0%e5%b9%b2%e9%a2%84%e6%8e%aa%e6%96%bd%e6%b2%bb%e7%96%97%e8%83%86","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=31234","title":{"rendered":"[JAMA Surg\u53d1\u8868\u8bba\u6587]\uff1a\u80c6\u56ca\u5207\u9664\u672f\u4e0eERCP\u6216\u65e0\u5e72\u9884\u63aa\u65bd\u6cbb\u7597\u80c6\u77f3\u75c7\u76f8\u5173\u6025\u6027\u80f0\u817a\u708e"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Cholecystectomy vs Endoscopic Retrograde Cholangiopancreatography or No Intervention After Gallstone-Related Acute Pancreatitis<\/h1>\n\n\n\n

Daniel Selin, Viktor Oskarsson, John Maret-Ouda, et al<\/h3>\n\n\n\n

JAMA Surg Published Online: June 24, 2026<\/h3>\n\n\n\n

doi: 10.1001\/jamasurg.2026.2168<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the risk of recurrence in gallstone-related acute pancreatitis according to index-admission management strategy?<\/p>\n\n\n\n

Findings<\/strong>  In this Swedish nationwide cohort study, recurrence was lowest after index-admission cholecystectomy. Endoscopic retrograde cholangiopancreatography (ERCP) alone was associated with similarly low long-term recurrence risk; however, other gallstone-related complications remained common.<\/p>\n\n\n\n

Meaning<\/strong>  These results suggest that same-admission cholecystectomy should be prioritized when feasible to prevent recurrent gallstone-related acute pancreatitis and other gallstone-related morbidity.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Same-admission cholecystectomy is recommended by guidelines for mild gallstone-related acute pancreatitis, yet surgery is often deferred. Endoscopic retrograde cholangiopancreatography (ERCP) is often used as an interim strategy, but its effectiveness compared with cholecystectomy is uncertain.<\/p>\n\n\n\n

Objective<\/strong>  To compare cholecystectomy, ERCP only, and no intervention in association with recurrent acute pancreatitis and other gallstone-related complications, accounting for death as a competing event.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This population-based cohort study used nationwide Swedish registries (2006-2019). Adults with first episodes of gallstone-related acute pancreatitis and a length of hospital stay 10 days or less were included. Follow-up began on the day after discharge. Fine-Gray subdistribution hazard models were applied in prespecified time windows (\u22647, 8-14, 15-30, 31-90, 91-365, and >365 days), adjusted for age, sex, socioeconomic factors, and comorbidities. These data were analyzed from September 2025 through January 2026.<\/p>\n\n\n\n

Exposures<\/strong>  Index-admission cholecystectomy, ERCP only, or no intervention; elective postdischarge cholecystectomy was modeled as a time-varying covariate.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was recurrent acute pancreatitis. The secondary outcome was other gallstone-related complications (acute cholecystitis and\/or choledocholithiasis).<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Among 9593 patients (median [IQR], age 61 [44-75] years; 60.3% female and 39.7% male), 28.7% underwent cholecystectomy, 16.9% ERCP only, and 54.4% no intervention during index hospital stay. Recurrence of acute pancreatitis in the 3 groups was 3.4%, 4.9%, and 17.5%, respectively. Similar differences were seen in adjusted models (overall subdistribution hazard ratio [sHR] for ERCP only, 1.40; 95% CI, 1.02-1.92 and for no intervention, 6.06; 95% CI, 4.85-7.56 compared with cholecystectomy). The risk of recurrence peaked 8 to 14 days after discharge among patients treated with ERCP only; beyond 15 days, there was no evidence of higher recurrence after ERCP only compared with cholecystectomy. Other gallstone-related complications occurred in 1.6% in the cholecystectomy group, 19.9% in the ERCP only group, and 16.3% in the no intervention group.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this study, same-admission cholecystectomy was associated with the lowest recurrence in acute pancreatitis and the lowest rate of other gallstone-related complications. ERCP only was associated with low long-term risk of recurrence but other gallstone-related complications remained common. These findings support prioritizing same-admission cholecystectomy in all individuals with acute gallstone-related pancreatitis, provided they are fit for surgery.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Cholecystectomy vs Endosco […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31234"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31234"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31234\/revisions"}],"predecessor-version":[{"id":31821,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31234\/revisions\/31821"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31234"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31234"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31234"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}