Should patients with coexisting alcoholism and cholelithiasis undergo cholecystectomy to prevent further attacks of acute pancreatitis?
No. Cholecystectomy does not prevent recurrent attacks of AP in patients with coexisting alcoholism because the disease almost always follows the pattern of alcohol-related pancreatitis. What are acute fluid collections? Acute fluid collections (AFC) occur in more than 50% of patients with moderate-to-severe AP. They are an accumulation of transudative or exudative fluid secondary to the local inflamed pancreatic tissue. They lack a clear wall of granulation tissue and are irregularly shaped. In general, they do not communicate directly with the pancreatic duct, and therefore do not have high pancreatic enzyme concentrations, as do pseudocysts. Acute fluid collections may occur as early as 48 hours after the onset of AP, with most resolving spontaneously by 4-6 weeks. However, 10-15% may develop a capsule and progress to pseudocyst formation. What are pseudocysts? Pancreatic pseudocysts are an accumulation of fluid containing necrotic tissue, debris, blood, and high concentrations of p
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