Following an episode of biliary pancreatitis, what is the preferred strategy to prevent recurrence after stabilization?

• A. Emergent cholecystectomy during initial attack
• B. Long-term antibiotics
• C. Elective cholecystectomy after stabilization
• D. Observation without surgery

Answer: (C)

The fundamental idea is that preventing recurrent biliary pancreatitis requires removing the source of the problem—the gallbladder containing the stones. Once the pancreatitis has resolved and the patient is stabilized, performing cholecystectomy eliminates gallstones and the ongoing risk of another episode. Doing surgery during the initial attack is riskier because of inflammation and edema, making dissection more difficult and increasing complications. Antibiotics don’t prevent recurrence since the issue is mechanically gallbladder obstruction, not infection, and just watching without removing the gallbladder leaves the risk of future episodes intact. Elective cholecystectomy after stabilization provides definitive protection against recurrence.