Duodenoscopy in treatment of acute gallstone pancreatitis.
OBJECTIVE
To probe the potential use of duodenoscopy in the diagnosis and treatment of acute gallstone pancreatitis (GP).


METHODS
Fourty-five patients with acute GP were randomly divided into endoscopic retrograde cholangiopancreatography (ERCP) group (n=20) and non-ERCP group (n=25). Each group was subdivided into mild and severe groups according to APACHE II scores. They were given supportive treatment combined with traditional Chinese medicine. The patients in the ERCP group received ERCP within 24 hours after admission. If there were stones in the common bile duct with stenosis of the inferior extremity or ampulla, endoscopic sphincterotomy (ES) was performed to extract the stones by basket. If no calculi were identified or multiple stones were large, endoscopic naso-biliary drainage (ENBD) was carried out.


RESULTS
The incidence of complication, length of hospitalization and cost were markedly lower in patients with severe acute GP in the ERCP group than those in the non-ERCP group (P<0.05), in contrast to the 2 mild subgroups of the ERCP and non-ERCP groups (P>0.05).


CONCLUSIONS
It is feasible, effective and safe to apply duodenoscopy in the treatment of severe acute GP.
Zhou
Ming-Qing
MQ
Department of Surgery, Central Hospital of Zhabei District, Shanghai 200070, China. zhoumingqing@163.net
Li
Neng-Ping
NP
Lu
Ren-Da
RD
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage; D004384:Duodenoscopy / Q000009:adverse effects / Q000191:economics; D005240:Feasibility Studies; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D016717:Sphincterotomy, Endoscopic