Roles of endoscopic sphincterotomy and cholecystectomy in acute biliary pancreatitis.
OBJECTIVE
We evaluated the natural course of biliary pancreatitis and compared the results obtained using endoscopic sphincterotomy (EST) and cholecystectomy.


METHODS
The medical records of 113 patients with biliary pancreatitis between January 1990 and April 2005 were analyzed retrospectively.


RESULTS
Twenty-five patients received no treatment and 15 (60.0%) of these experienced recurrence during a mean follow-up period of 36.0 months. Fifty-two received EST only, and no recurrence occurred during a mean follow-up of 29.8 months. Thirty-six patients underwent cholecystectomy and 1 (2.8%) patient experienced the second attack during a follow-up of 35.2 months. Acute cholecystitis developed in 7 of 77 (9.1%) patients who did not receive cholecystectomy during a mean follow-up period of 33.3 months, and was found to be prone to develop in patients with both gall bladder (GB) and common bile duct (CBD) stones.


CONCLUSIONS
Sixty percent of patients with biliary pancreatitis experienced relapses without treatment, and cholecystectomy with or without EST tended to reduce recurrence. Cholecystectomy might not be a routine treatment after EST especially in the old because the incidence of acute cholecystitis was relatively low within 3 years and be recommended for patients with both visible GB and CBD stones at presentation.
Lee
Jun Kyu
JK
Department of Internal Medicine, Dongguk University International Hospital, Dongguk University College of Medicine, Goyang, Korea.
Ryu
Ji Kon
JK
Park
Joo Kyung
JK
Yoon
Won Jae
WJ
Lee
Sang Hyub
SH
Hwang
Jin-Hyeok
JH
Kim
Yong-Tae
YT
Yoon
Yong Bum
YB
D000208:Acute Disease; D002763:Cholecystectomy; D041881:Cholecystitis, Acute / Q000453:epidemiology; D005260:Female; D042882:Gallstones / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000097:blood / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic