Study on association between gallstone size and pancreatitis

Acute Pancreatitis is the most common pancreatic disease. Various factors are believed to be involved in causing acute pancreatitis in patients of cholelithiasis like multiple gallstones, small gallstones, biliary sludge, wide cystic duct, choledocholithiasis and presence of a common channel. Small gallstones might migrate into the common bile duct more easily than larger stones 8. The present study was done to find out any association between small sized gallstones and developing acute pancreatitis. This study included 70 patients between 1st June 2016 to 31st May 2017, who presented with acute pancreatitis in the emergency department or surgical outpatient department with presence of gallstones on ultrasound of abdomen. Ultrasonography of all patients was done to detect gallstones. Number, size of the largest and the smallest gallstone, thickness of gall bladder wall, presence of pericholecystic fluid, condition of pancreas and its size, echogenicity, peripancreatic collection, presence or absence of ascites, condition of Common Bile Duct (CBD), its diameter, presence or absence of CBD stones were noted in all cases. The patients were divided into 5 mm categories according to smallest stone size. Maximum number of patients, i.e. 46 (65.7%), were observed in ≤5mm category. In this study we found that multiple small gallstones were associated with acute gallstone induced pancreatitis. Therefore patients with multiple small size gallstones require early surgery to reduce incidence of gallstone induced pancreatitis and its complications.