title: Roles of endoscopic sphincterotomy and cholecystectomy in acute biliary pancreatitis.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Dongguk University International Hospital, Dongguk University College of Medicine, Goyang, Korea.
authors.forename: Jun Kyu
authors.initials: JK
authors.lastname: Lee
authors.forename: Ji Kon
authors.initials: JK
authors.lastname: Ryu
authors.forename: Joo Kyung
authors.initials: JK
authors.lastname: Park
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Yoon
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Jin-Hyeok
authors.initials: JH
authors.lastname: Hwang
authors.forename: Yong-Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Yoon
mesh_terms: 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