Diagnostic evaluation prior to cholecystectomy in mild-moderate acute biliary pancreatitis.
OBJECTIVE
The importance of papillary obstruction in the pathogenesis of acute biliary pancreatitis (ABP) is widely recognized. The aim of this study was to evaluate the usefulness of the MRCP before the VLC in the patients with mild acute biliary pancreatitis.


METHODS
In the period 2003-2008, 47 patients were submitted to a MRCP (F/M: 28/19) with mild ABP without increase of the cholestasis tests and absence of choledocholithiasis at the abdominal US. During a follow up from 30 to 60 days after the VLC, the presence of jaundice or relapse of ABP were evaluated in all patients.


RESULTS
Thirteen patients had diagnosis of choledocholithiasis at the MRCP and they were submitted to an ERCP endoscopic sphincterotomy and stones removal; 34 patients with a negative MRCP were submitted to the VLC. Among these, on 10th postoperative days, one patient has had recurrent ABP, and was submitted to ERCP/ES. All the 47 patients submitted to the MRCP before the VLC did not have jaundice or relapse of the ABP during the follow-up period.


CONCLUSIONS
The MRCP was an accurate investigation for the preoperatory diagnosis of choledocholithiasis; even if it is not possible to recommend its utilization extensively, it is an important procedure for the patients with diagnosis of mild ABP to select all those to submit to the ERCP.
Department of Surgical Sciences, Division of General Surgery, University of Foggia, Polyclinic Ospedali Riuniti, Foggia, Italy. v.neri@unifg.it
Vincenzo
V
Neri
Alberto
A
Fersini
Antonio
A
Ambrosi
Nicola
N
Tartaglia
Tiziano Pio
TP
Valentino
D000208:Acute Disease; D000328:Adult; D000368:Aged; D049448:Cholangiopancreatography, Magnetic Resonance; D002763:Cholecystectomy; D002779:Cholestasis / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D011300:Preoperative Care; D012720:Severity of Illness Index