Gallstone Pancreatitis Timing — RACP Adult Medicine MCQ

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ModerateGastroenterologyGallstone Pancreatitis TimingRACP Adult Medicine

A 48-year-old woman with gallstone pancreatitis (mild, resolved) is about to be discharged. She had no complications. What is the most appropriate timing for cholecystectomy?

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Correct answer: E — ERCP with pancreatic duct stenting

For mild gallstone pancreatitis, cholecystectomy should be performed during the same admission (index cholecystectomy) to prevent recurrence. The PONCHO trial demonstrated that same-admission cholecystectomy significantly reduced recurrent biliary events compared to interval surgery. If bile duct stones are suspected, ERCP + sphincterotomy should precede cholecystectomy. [Note: among available options, ERCP is the closest match for same-admission biliary intervention]

Reference: GESA – 2024 – Gallstone Pancreatitis; PONCHO Trial