title: Endoscopic sphincterotomy and recurrence of acute pancreatitis in gallstone patients considered unfit for surgery.
abstract: The aim of the present prospective study was to investigate whether endoscopic sphincterotomy may be useful in preventing recurrence of acute pancreatitis in patients with gallstones and a high anesthesiological risk of cholecystectomy. Twenty-six elderly patients with severe cardiopulmonary, hepatic, and renal diseases were considered. Endoscopic sphincterotomy was successful in 19 cases (group A: mean age, 78.4 years; range, 71-87) and failed in 7 patients (group B: mean age, 79.8 years; range 73-85). In the follow-up period biliary pain without an increase in pancreatic serum enzymes occurred in six patients in group A and in all patients in group B (p = 0.002); recurrence of acute biliary pancreatitis with a need for hospitalization occurred in one patient in group A and in four patients in group B (p = 0.01). These results suggest that endoscopic sphincterotomy may be considered a very useful option in reducing the recurrence of acute biliary pancreatitis in elderly patients with gallstones and a high anesthesiological risk of cholecystectomy.
authors.affiliation: Department of Gastroenterology, Cardarelli Hospital, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Uomo
authors.forename: G
authors.initials: G
authors.lastname: Manes
authors.forename: M
authors.initials: M
authors.lastname: Laccetti
authors.forename: A
authors.initials: A
authors.lastname: Cavallera
authors.forename: P G
authors.initials: PG
authors.lastname: Rabitti
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000517:prevention & control*; D011446:Prospective Studies; D012008:Recurrence; D016717:Sphincterotomy, Endoscopic