CHSJ

Curr Health Sci J, vol. 52, no. 1, 2026

Management of Acute Biliary Pancreatitis in Practice Setting of a Multidisciplinary Hospital

[Original Paper]

A.L. DIMA(1), D.I. VOICULESCU(2), A.L. MANDA(3), D.V. DAVITOIU(2)


(1)Department of Surgery, Doctoral School Carol Davila University of Medicine and Pharmacy Bucharest;
(2)Department of Surgery, Carol Davila University of Medicine and Pharmacy Bucharest;
(3)Emergency University Hospital Bucharest, 1st Surgery Clinic


Abstract:

Management of acute biliary pancreatitis involves collaboration between medical specialties-surgery, gastroenterology, interventional endoscopy, intensive care in different algorithms. We conducted an analytical retrospective study of 139 subjects diagnosed with acute biliary pancreatitis admitted in the time interval between January 2017 and September 2025. Pancreatitis form was mild or moderate in 128 cases and severe from the onset in 11 cases. All patients benefited from early conservative treatment and most (109) from ERCP and/or cholecystectomy during hospitalization, with favorable outcome in all cases of mild and moderate pancreatitis. Statistical analysis showed that for predictors of severe disease, prolonged evolution and poor outcome at admission, only glycemia was significantly higher in patients with unfavorable evolution (p=0.031). At 48 hours, statistically significant differences were identified for urea (p=0.0047), fibrinogen (p=0.041), lipase (p=0.049), and glycemia (p=0.01). At 72 hours, significant differences persisted for urea (p=0.0024), fibrinogen (p=0.018), and lipase (p=0.016). Exploratory predictive analysis performed showed urea at 72 hours with the strongest positive association with unfavorable clinical outcome (OR 1.06) in the logistic regression model, while Random Forest analysis identified urea at 72 hours, lipase at 72 hours, and admission laboratory parameters as the most relevant contributors to unfavorable clinical evolution. Both tested models have limited predictive performance, and the findings should be interpreted as exploratory. The results emphasize the value of a stepwise, multidisciplinary management strategy combined with dynamic biological assessment for optimizing therapeutic decisions and prognostic evaluation in acute biliary pancreatitis.


Keywords: Acute biliary pancreatitis, cholecystectomy, ERCP.



Corresponding: Daniel Iulian Voiculescu, Department of Surgery, Carol Davila University of Medicine and Pharmacy Bucharest, e-mail: daniel.voiculescu@umfcd.ro


DOI 10.12865/CHSJ.52.01.10 - Download PDF
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