Early endoscopic cholangiopancreatography and sphincterotomy in acute biliary pancreatitis: report of 50 cases.
Endoscopic retrograde cholangiopancreatography (ERCP) was successfully performed in 49/50 consecutive patients with acute pancreatitis and suspected biliary aetiology in the early phases of the disease (24-72 hours from admission). ERCP showed common bile duct lithiasis and/or stenosis (25 cholecystectomized patients) in 41/49 cases (83.7%). In 38 patients endoscopic sphincterotomy (ES) was performed: stone removal was possible in lithiasic patients (36 cases, 13 previously cholecystectomized); 3 further patients showed a main pancreatic duct stenosis (2 of these underwent pancreatic ES). The patients treated with ES showed a quick improvement in symptomatology and clinical outcome; no adverse effect of ERCP was found; no mortality was registered. Comparison with a previous series of 130 cases of acute biliary pancreatitis (ABP) showed a reduction in mortality, complications and length of hospitalization. These findings suggest that, from a diagnostic and therapeutic point of view, early ERCP is safe and useful in ABP.
Uomo
G
G
Centro Malattie Pancreas, Ospedale Cardarelli, Napoli, Italy.
Galloro
V
V
Rabitti
P G
PG
Marcopido
B
B
Laccetti
M
M
Visconti
M
M
D000208:Acute Disease; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003137:Common Bile Duct Diseases / Q000150:complications; D003251:Constriction, Pathologic / Q000150:complications; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D011446:Prospective Studies; D016717:Sphincterotomy, Endoscopic; D013997:Time Factors