skip to main content

Gallstone pancreatitis follow-up — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardSurgery (Post-operative / Follow-up)Gallstone pancreatitis follow-upUSMLE Step 3

A 47-year-old woman is recovering from mild gallstone pancreatitis. She is tolerating food, pain has resolved, bilirubin is normal, ultrasound shows gallstones without common-duct dilation, and there is no cholangitis, necrosis, or organ failure. Which management best reduces recurrence?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Perform laparoscopic cholecystectomy before discharge from this hospitalization

The best answer is “Perform laparoscopic cholecystectomy before discharge from this hospitalization”. In mild acute biliary pancreatitis, cholecystectomy during the index admission substantially reduces recurrent pancreatitis and biliary events without the delay required after severe necrotizing disease. Urgent ERCP is reserved for cholangitis or persistent biliary obstruction. Normalizing bilirubin and absent duct dilation make preoperative ERCP unnecessary, but they do not remove the gallbladder source.

Reference: AGA Guideline: Initial Management of Acute Pancreatitis: https://gastro.org/clinical-guidance/initial-management-of-acute-pancreatitis-ap/