{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:26:56Z","timestamp":1789666016841,"version":"4.0.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T00:00:00Z","timestamp":1611705600000},"content-version":"vor","delay-in-days":370,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Occult biliary disease has been suggested as a frequent underlying cause of idiopathic acute pancreatitis (IAP). Cholecystectomy has been proposed as a strategy to prevent recurrent IAP. The aim of this systematic review was to determine the efficacy of cholecystectomy in reducing the risk of recurrent IAP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>PubMed, Embase and Cochrane Library databases were searched systematically for studies including patients with IAP treated by cholecystectomy, with data on recurrence of pancreatitis. Studies published before 1980 or including chronic pancreatitis and case reports were excluded. The primary outcome was recurrence rate. Quality was assessed using the Newcastle\u2013Ottawa Scale. Meta-analyses were undertaken to calculate risk ratios using a random-effects model with the inverse-variance method.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, ten studies were included, of which nine were used in pooled analyses. The study population consisted of 524 patients with 126 cholecystectomies. Of these 524 patients, 154 (29\u00b74 (95 per cent c.i. 25\u00b75 to 33\u00b73) per cent) had recurrent disease. The recurrence rate was significantly lower after cholecystectomy than after conservative management (14 of 126 (11\u00b71 per cent) versus 140 of 398 (35\u00b72 per cent); risk ratio 0\u00b744, 95 per cent c.i. 0\u00b727 to 0\u00b771). Even in patients in whom IAP was diagnosed after more extensive diagnostic testing, including endoscopic ultrasonography or magnetic resonance cholangiopancreatography, the recurrence rate appeared to be lower after cholecystectomy (4 of 36 (11 per cent) versus 42 of 108 (38\u00b79 per cent); risk ratio 0\u00b741, 0\u00b716 to 1\u00b707).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Cholecystectomy after an episode of IAP reduces the risk of recurrent pancreatitis. This implies that current diagnostics are insufficient to exclude a biliary cause.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.11429","type":"journal-article","created":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T05:45:42Z","timestamp":1577339142000},"page":"191-199","source":"Crossref","is-referenced-by-count":50,"title":["Recurrence of idiopathic acute pancreatitis after cholecystectomy: systematic review and meta-analysis"],"prefix":"10.1093","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4872-8389","authenticated-orcid":false,"given":"D S","family":"Umans","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N D","family":"Hallensleben","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Erasmus MC University Medical Centre , Rotterdam,","place":["the Netherlands"]},{"name":"Department of Research and Development, St Antonius Hospital , Nieuwegein,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R C","family":"Verdonk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, St Antonius Hospital , Nieuwegein,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S A W","family":"Bouwense","sequence":"additional","affiliation":[{"name":"Department of Surgery, MUMC+ , Maastricht,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Fockens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H C","family":"Santvoort","sequence":"additional","affiliation":[{"name":"Department of Surgery, St Antonius Hospital , Nieuwegein,","place":["the Netherlands"]},{"name":"Department of Surgery, UMC Utrecht , Utrecht,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R P","family":"Voermans","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M G","family":"Besselink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M J","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Erasmus MC University Medical Centre , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"van Hooft","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,1]]},"reference":[{"key":"2024092914191578300_bjs11429-bib-0001","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.pan.2017.01.005","article-title":"The incidence and aetiology of acute pancreatitis across Europe","volume":"17","author":"Roberts","year":"2017","journal-title":"Pancreatology"},{"key":"2024092914191578300_bjs11429-bib-0002","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ijsu.2015.07.701","article-title":"Epidemiology, aetiology and outcomes of acute pancreatitis: a retrospective cohort study","volume":"23","author":"Nesvaderani","year":"2015","journal-title":"Int J Surg"},{"key":"2024092914191578300_bjs11429-bib-0003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/MPA.0b013e3182572d3a","article-title":"The epidemiology of idiopathic acute pancreatitis, analysis of the nationwide inpatient sample from 1998 to 2007","volume":"42","author":"Chen","year":"2013","journal-title":"Pancreas"},{"key":"2024092914191578300_bjs11429-bib-0004","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1056\/NEJM199202273260902","article-title":"Biliary sludge as a cause of acute pancreatitis","volume":"326","author":"Lee","year":"1992","journal-title":"N Engl J Med"},{"key":"2024092914191578300_bjs11429-bib-0005","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.cgh.2006.06.023","article-title":"Is biliary microlithiasis a significant cause of idiopathic recurrent acute pancreatitis? A long-term follow-up study","volume":"5","author":"Garg","year":"2007","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2024092914191578300_bjs11429-bib-0006","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.bpg.2006.03.007","article-title":"Gallstone disease: microlithiasis and sludge","volume":"20","author":"J\u00fcngst","year":"2006","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"2024092914191578300_bjs11429-bib-0007","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1016\/S0140-6736(15)00274-3","article-title":"Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): a multicentre randomised controlled trial","volume":"386","author":"da Costa","year":"2015","journal-title":"Lancet"},{"key":"2024092914191578300_bjs11429-bib-0008","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1097\/SLA.0000000000001469","article-title":"Can laparoscopic cholecystectomy prevent recurrent idiopathic acute pancreatitis?: A prospective randomized multicenter trial","volume":"262","author":"R\u00e4ty","year":"2015","journal-title":"Ann Surg"},{"key":"2024092914191578300_bjs11429-bib-0009","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1007\/s11605-016-3269-x","article-title":"How does cholecystectomy influence recurrence of idiopathic acute pancreatitis?","volume":"20","author":"Stevens","year":"2016","journal-title":"J Gastrointest Surg"},{"key":"2024092914191578300_bjs11429-bib-0010","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1016\/j.gie.2017.11.028","article-title":"Comparison of EUS with MRCP in idiopathic acute pancreatitis: a systematic review and meta-analysis","volume":"87","author":"Wan","year":"2018","journal-title":"Gastrointest Endosc"},{"key":"2024092914191578300_bjs11429-bib-0011","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"2024092914191578300_bjs11429-bib-0012","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA"},{"key":"2024092914191578300_bjs11429-bib-0013","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.pan.2013.07.063","article-title":"IAP\/APA evidence-based guidelines for the management of acute pancreatitis","volume":"13","author":"Working Group IAP\/APA Acute Pancreatitis Guidelines","year":"2013","journal-title":"Pancreatology."},{"key":"2024092914191578300_bjs11429-bib-0014","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Classification of acute pancreatitis \u2013 2012: revision of the Atlanta classification and definitions by international consensus","volume":"62","author":"Banks","year":"2013","journal-title":"Gut"},{"key":"2024092914191578300_bjs11429-bib-0015","volume-title":"The Newcastle-Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses","author":"Wells","year":"2012"},{"key":"2024092914191578300_bjs11429-bib-0016","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"2024092914191578300_bjs11429-bib-0017","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/S0895-4356(01)00377-8","article-title":"Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis","volume":"54","author":"Sterne","year":"2001","journal-title":"J Clin Epidemiol"},{"key":"2024092914191578300_bjs11429-bib-0018","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/S0895-4356(00)00242-0","article-title":"Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature","volume":"53","author":"Sterne","year":"2000","journal-title":"J Clin Epidemiol"},{"key":"2024092914191578300_bjs11429-bib-0019","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.surg.2011.07.017","article-title":"Lack of significant liver enzyme elevation and gallstones and\/or sludge on ultrasound on day 1 of acute pancreatitis is associated with recurrence after cholecystectomy: a population-based study","volume":"151","author":"Trna","year":"2012","journal-title":"Surgery"},{"key":"2024092914191578300_bjs11429-bib-0020","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/j.1572-0241.1998.00360.x","article-title":"Bilirubinate granules: main pathologic bile component in patients with idiopathic acute pancreatitis","volume":"93","author":"P\u00e9rez-Mart\u00edn","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"2024092914191578300_bjs11429-bib-0021","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1111\/j.1440-1746.2004.03462.x","article-title":"Biliary microlithiasis in patients with idiopathic acute pancreatitis and unexplained biliary pain: response to therapy","volume":"19","author":"Saraswat","year":"2004","journal-title":"J Gastroenterol Hepatol"},{"key":"2024092914191578300_bjs11429-bib-0022","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S0016-5107(00)70382-8","article-title":"EUS for detection of occult cholelithiasis in patients with idiopathic pancreatitis","volume":"51","author":"Liu","year":"2000","journal-title":"Gastrointest Endosc"},{"key":"2024092914191578300_bjs11429-bib-0023","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/MPA.0b013e318201654a","article-title":"Prospective comparison of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in the etiological diagnosis of \u2018idiopathic\u2019 acute pancreatitis","volume":"40","author":"Ortega","year":"2011","journal-title":"Pancreas"},{"key":"2024092914191578300_bjs11429-bib-0024","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1111\/j.1572-0241.2001.03609.x","article-title":"Endoscopic ultrasound in idiopathic acute pancreatitis","volume":"96","author":"Tandon","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"2024092914191578300_bjs11429-bib-0025","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s11894-010-0170-8","article-title":"Pancreas divisum","volume":"13","author":"DiMagno","year":"2011","journal-title":"Curr Gastroenterol Rep"},{"key":"2024092914191578300_bjs11429-bib-0026","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.cgh.2015.12.040","article-title":"Risk of recurrent pancreatitis and progression to chronic pancreatitis after a first episode of acute pancreatitis","volume":"14","author":"Ahmed Ali","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2024092914191578300_bjs11429-bib-0027","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1038\/ajg.2016.240","article-title":"Prospective endoscopic ultrasound-based approach to the evaluation of idiopathic pancreatitis: causes, response to therapy, and long-term outcome","volume":"111","author":"Wilcox","year":"2016","journal-title":"Am J Gastroenterol"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.11429","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/107\/3\/191\/59433486\/bjs11429.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/107\/3\/191\/59433486\/bjs11429.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T14:19:28Z","timestamp":1727619568000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/107\/3\/191\/6121064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,23]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,2,1]]},"published-print":{"date-parts":[[2020,1,23]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.11429","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,2]]},"published":{"date-parts":[[2020,1,23]]}}}