Acute and subacute pancreatitis. Role of surgery and endoscopic retrograde cholangiopancreatography.
Six of seven patients with acute pancreatitis who were intractable to prolonged medical therapy underwent successful endoscopic retrograde cholangiopancreatography (ERCP) followed by immediate operative therapy. All of these patients had surgically correctable lesions consistent with chronic pancreatitis. There was one associated mortality and no morbidity. The conditions of the surviving six patients were significantly improved in the immediate postoperative period, and long-term follow-up has been encouraging. Pancreaticojejunostomy and conservative resection appeared to have good results. The timing of the operation immediately after ERCP in patients with acute pancreatic pathology eliminated problems with exacerbation or sepsis. Patients whose clinical conditions do not improve with aggressive medical therapy for acute pancreatitis may have both chronic and acute disease that is amenable to operative therapy.
D000208:Acute Disease; D000328:Adult; D002758:Cholangiography; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging; D010180:Pancreatectomy; D010195:Pancreatitis / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D011183:Postoperative Complications; D012008:Recurrence