Minimally invasive treatment of acute biliary pancreatitis.
BACKGROUND
Stones of the common bile duct are the most important factor in acute pancreatitis (AP). Endolaparoscopic surgery plays a well-recognized role in the treatment of this pathology.


METHODS
From January 1992 to December 1995 we observed 62 cases of acute biliary pancreatitis (ABP). In 57 cases (= 93.4%) we proposed a minimally invasive treatment, based on performance of endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (ES) and then of laparoscopic cholecystectomy (LC).


RESULTS
ERCP was attempted in emergency in 40/57 cases and successfully done in 34 cases. An ES was performed in all but two cases. In 51 patients we performed LC. The overall morbidity was 8. 9% with no mortality.


CONCLUSIONS
In the case of ABP early treatment can achieve the restoration of patency of the papilla, reducing the risk of associated cholangitis and the development of pancreatic necrosis. The cholecystectomy prevents the risk of relapse of ABP.
Ricci
F
F
First Department of General Surgery, University of Verona, 37126 Verona, Italy.
Castaldini
G
G
de Manzoni
G
G
Borzellino
G
G
Rodella
L
L
Kind
R
R
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D002761:Cholangitis / Q000517:prevention & control; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D004630:Emergencies; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009336:Necrosis; D010179:Pancreas / Q000473:pathology; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects; D015996:Survival Rate; D016896:Treatment Outcome