[Bile duct surgery in acute pancreatitis].
Established principles of biliary surgery in connection with biliary pancreatitis include cholecystectomy to prevent recurrence of pancreatitis and biliary drainage if an impacted papillary stone is present. Controversies persist with regard to laparoscopic cholecystectomy and with regard to the timing of ERC and endoscopic papillotomy. The role of early prophylactic ERC has become more clear when in 1988 Carr Locke and coworkers presented a prospective series of patients randomised for different management modalities and stratified according to severity of the pancreatitis. Thus the current recommendation is to plan early ERC and papillotomy for those patients who, according to one of the severity scoring systems, are at risk for a complicated course. Patients with predicted mild disease will not profit from this procedure and are unnecessarily exposed to its risks.
Schuppisser
J P
JP
Allgemeinchirurgische Abteilung, St. Claraspital, Basel.
D000208:Acute Disease; D002763:Cholecystectomy; D042882:Gallstones / Q000473:pathology / Q000601:surgery*; D006801:Humans; D009336:Necrosis; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy; D010195:Pancreatitis / Q000473:pathology / Q000601:surgery*; D016717:Sphincterotomy, Endoscopic
Gallenwegschirurgie bei akuter Pankreatitis.