Relapses of biliary acute pancreatitis in patients with previous attack of biliary pancreatitis and gallbladder in situ.
OBJECTIVE
To evaluate relapse of acute pancreatitis in patients with biliary pancreatitis in whom coexisting diseases or patient refusal have excluded cholecystectomy.


METHODS
Forty-seven patients presenting a first episode of biliary acute pancreatitis underwent urgent endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES).


RESULTS
ERCP with ES was successful in all but one patient (97.8%) who was then cholecystectomised. Complications related to the endoscopic procedure were reported in five patients (10.6%). During the follow-up period (median time 12 months; range 1-84 months), 10 patients (21%) suffered from biliary complications. Three patients (6.4%), all with lithiasis of the gallbladder, had relapses of acute pancreatitis, two of them within 2 months of the previous episode, and one about a year later after ingestion of a rich meal and alcoholic beverages. The first two were cholecystectomised. Two patients died during the follow-up period from unrelated diseases.


CONCLUSIONS
In subjects who are at high risk for anaesthesia, endoscopic procedures may be utilised.
Billi
P
P
Department of Internal Medicine, Sant'Orsola-M. Malpigli Hospital, Bologna, Italy.
Barakat
B
B
D'Imperio
N
N
Pezzilli
R
R
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D005260:Female; D005704:Gallbladder / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000601:surgery* / Q000628:therapy; D011446:Prospective Studies; D012008:Recurrence; D016717:Sphincterotomy, Endoscopic; D016312:Treatment Refusal