Acute biliary pancreatitis, endoscopy, and laparoscopy.
Current practices for diagnosis and treatment of common bile duct stones are not evidence-based. Acute biliary pancreatitis (ABP) is a specific situation in which endoscopic procedures are either overused or misused. Pancreatitis is a poor marker for choledocholithiasis. Prognostic systems are accurate to discern those patients with ABP who do not need aggressive procedures. Patients with a benign ABP do not need an endoscopic approach. Laparoscopic common bile duct exploration is an underrated treatment for patients with choledocholithiasis. Laparoscopic approach to infected necrotic collections and pseudocysts warrant further investigations.
Borie
F
F
Department of Visceral Surgery A, Hôpital Saint-Eloi, University Hospital Center Montpellier, Avenue Augustin Fliche 80, F-34295 Montpellier Cedex 5, France.
Fingerhut
A
A
Millat
B
B
D000208:Acute Disease; D001652:Bile Ducts / Q000293:injuries; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic; D042883:Choledocholithiasis / Q000150:complications* / Q000000981:diagnostic imaging; D000075202:Contraindications; D016145:Endoscopy, Digestive System; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging; D010535:Laparoscopy; D010192:Pancreatic Pseudocyst / Q000601:surgery; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery*; D019283:Pancreatitis, Acute Necrotizing / Q000209:etiology / Q000601:surgery; D015641:Radiography, Interventional; D012720:Severity of Illness Index; D016717:Sphincterotomy, Endoscopic