- The Washington Times - Tuesday, March 9, 2004

Doctors at George Washington University Hospital removed Attorney General John Ashcroft’s gallbladder yesterday in an operation designed to treat a severe bout of pancreatitis that sent the nation’s top prosecutor to the emergency room last week.

“Everything went as planned. He’s in guarded condition, which is normal after such a procedure,” said Dr. Bruce Abell, who performed the two-hour surgery, known as a cholecystectomy.

Mr. Ashcroft, 61, is expected to remain in the hospital for the next four to five days. His long-term prognosis was described by Dr. Abell as “excellent.”

The attorney general had been in the hospital’s intensive-care unit since Thursday night, when doctors diagnosed gallstone-caused pancreatitis, a painful illness involving inflammation of the pancreas. Dr. Abell said surgery was necessary because Mr. Ashcroft had “several gallstones remaining in his gallbladder that are of concern to us.”

The procedure used to remove the gallbladder was performed laparoscopically, which involves the use of general anesthesia and a tiny fiber-optic camera inserted through a small incision, allowing quicker recovery than the traditional approach of open surgery, hospital officials said.

Dr. Abell, director of surgical critical care at the hospital, began the surgery after he and other doctors were sure Mr. Ashcroft’s pancreatitis had improved to a point where he was stable enough to withstand surgery. He said when the gallbladder is not removed, up to 50 percent of patients have a recurrence of pancreatitis within six weeks.

He said doctors located several gallstones in Mr. Ashcroft’s gallbladder, any one of which could have caused a reoccurrence of pancreatitis, which can be fatal. He said the gallbladder was removed through Mr. Ashcroft’s navel.

“This procedure was performed as a preventative measure,” Dr. Abell told reporters.

Mr. Ashcroft has canceled his schedule for the week. Deputy Attorney General James B. Comey, named in October to succeed Larry D. Thompson, was empowered to act for Mr. Ashcroft while he is being treated.

According to officials at the Mayo Clinic, pancreatitis often is caused by gallstones leaving the gallbladder and lodging near and obstructing the pancreatic duct. The obstruction, they said, can cause an intense, constant pain in the upper abdomen that may radiate to the back or chest.

Symptoms include nausea, vomiting, high fever, difficulty in breathing and abdominal bruises from internal bleeding, they said. Pain can be severe, the officials added, noting on the Mayo Clinic Web page: “It’s a stomachache like you’ve never had before.”

The National Institutes of Health said about 80,000 cases of pancreatitis occur in the United States each year, and about 20 percent of them are severe. The NIH said acute pancreatitis can be life-threatening.

The gallbladder is a small, pear-shaped organ that stores and concentrates bile produced by the liver, which is used to emulsify fats and neutralize acids in partly digested food. The pancreas is the organ responsible for producing insulin, which regulates blood-sugar levels.

Mr. Ashcroft, a former Missouri state auditor, attorney general, governor and U.S. senator, was nominated as U.S. attorney general by President-elect Bush in December 2000. A conservative Republican, Mr. Ashcroft had lost his re-election bid to Missouri Gov. Mel Carnahan, who died in a plane crash three weeks before Election Day.

Mr. Ashcroft survived five weeks worth of opposition from Democrats and liberal civil rights groups to become the 79th U.S. attorney general.

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