title: [Treatment of acute biliary pancreatitis: our experience].
abstract: The results of endoscopic and surgical treatment in 21 patients affected by acute biliary pancreatitis are reported. All patients were managed according to the same protocol. Once the diagnosis was formulated (pain, serum amylase, ultrasonography, cholestasis and/or cholangitis) and the severity evaluated (Ranson's criteria, glucose and urea levels), the 21 patients underwent endoscopic retrograde cholangiopanctratography--within 24 hours in 8 patients (predicted severe disease) or within 72 hours in 13 patients (predicted mild disease). Endoscopic sphincterotomy was performed in 18 patients with stones in the common bile duct and was successful in 94.5% (17 patients: 3 patients underwent more than one session to confirm or achieve clearance of the duct). The morbidity rate associated with endoscopic sphincterotomy was 16% (3 patients: 2 haemorrhages, 1 perforation). There were no deaths. Cholecystectomy was performed in 16 patients within 2-9 weeks of the initial attack of acute biliary pancreatitis. There were 3 minor complications (respiratory, laparotomy, urinary infection), no major intraoperative or postoperative morbidity, and no mortality. Acute biliary pancreatitis is still associated with significant morbidity and mortality, but can be managed safely with combined medical, endoscopic and surgical treatment.
authors.affiliation: Cattedra di Semeiotica Chirurgica, Dipartimento di Chirurgia, Università degli Studi di Genova.
authors.forename: Rosario
authors.initials: R
authors.lastname: Fornaro
authors.forename: Milvia
authors.initials: M
authors.lastname: Canaletti
authors.forename: Maria Doris
authors.initials: MD
authors.lastname: Davini
authors.forename: Camilla
authors.initials: C
authors.lastname: Sticchi
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Bianchi
authors.forename: Eva
authors.initials: E
authors.lastname: Moraglia
authors.forename: Francesca
authors.initials: F
authors.lastname: Mandolfino
authors.forename: Monica
authors.initials: M
authors.lastname: Capellino
authors.forename: Eno
authors.initials: E
authors.lastname: Picori
authors.forename: Antonio
authors.initials: A
authors.lastname: Terrizzi
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002763:Cholecystectomy; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000601:surgery*