A preliminary report: urgent duodenoscopic sphincterotomy for acute gallstone pancreatitis.
Eleven patients wtih gallstone-related acute pancreatitis underwent urgent duodenoscopy and diathermy sphincterotomy; six had stones impacted at the papilla of Vater, and the remainder had stones in the bile duct. One patient had a gallstone in the pancreatic duct. Endoscopic removal of the duct stones resulted in a prompt, persistent clinical and biochemical improvement, except in one patient who had been referred from another hospital with a pseudocyst 3 weeks after the onset of illness. Pancreatography results were remarkably normal in the remaining patients. Use of emergency biliary decompression in patients with acute gallstone-related pancreatitis remains controversial, and the indications need clarification. However our results justify further evaluation of duodenoscopic sphincterotomy as an alternative to surgery.
D000208:Acute Disease; D000368:Aged; D014670:Ampulla of Vater / Q000601:surgery*; D002769:Cholelithiasis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004384:Duodenoscopy; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography