title: Biliary Pancreatitis. Liver Function Tests and Common Biliopancreatic Channel Kinetics--Biliopancreatic Reflux.
abstract: OBJECTIVE
  To determine the prevalence of biliopancreatic reflux (BPR) in patients with biliary pancreatitis (BP) undergoing elective cholecystectomy with intraoperative cholangiography (IOC) in comparison with a control group of symptomatic cholelithiasis (CG).
  
  
  METHODS
  Retrospective review of 107 consecutive BP cases. BPR was determined by IOC and liver function tests (LFT) were recorded at admission (A), 48hours, and preoperative examination (P). LFT analysis between A and P were analysed between groups with respect to BPR, time interval to cholecystectomy within the same group and by determination of observed value/maximum normal value ratio (OV/MNV).
  
  
  RESULTS
  BPR incidence was 38.3% in BP in comparison with 5% in CG (p=0.0001) it was independent from interval time to cholecystectomy, in contrast with Odditis, suggesting an anatomical condition for CCBP and a functional one for Odditis. LFT analysis showed no differences in relation to BPR incidence. LFT excluding AP and GGT returned to normal values with significant differences in OV/MNV when BPR was present which points to an increased cholestasis in BPR group. US dilatation of CBD was noted in 10.3% and was associated to CCBP.
  
  
  CONCLUSIONS
  BPR in BP increases cholestasis and contributes to confusion in the estimation of common bile duct stones increasing ERCP-EE rates. US and biochemical markers of CBDS show a low specificity due to BPR-CCBP which suggests that MRI-cholangiography is a mandatory exploration before ERCP-EE examination.
authors.affiliation: Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía, Hospital Francisco de Borja, Gandía, Valencia, España. Electronic address: planells.mvi@gmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Planells Roig
authors.affiliation: Servicio de Cirugía, Hospital Francisco de Borja, Gandía, Valencia, España.
authors.forename: Úrsula
authors.initials: Ú
authors.lastname: Ponce Villar
authors.affiliation: Unidad de Cirugía Hepatobiliopancreática, Servicio de Cirugía, Hospital Francisco de Borja, Gandía, Valencia, España.
authors.forename: Fabián
authors.initials: F
authors.lastname: Peiró Monzó
authors.affiliation: Servicio de Cirugía, Hospital Francisco de Borja, Gandía, Valencia, España.
authors.forename: Alba
authors.initials: A
authors.lastname: Coret Franco
authors.affiliation: Servicio de Cirugía, Hospital Francisco de Borja, Gandía, Valencia, España.
authors.forename: Natalia
authors.initials: N
authors.lastname: Orozco Gil
authors.affiliation: Servicio de Cirugía, Hospital Francisco de Borja, Gandía, Valencia, España.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Bañuls Matoses
authors.affiliation: Servicio de Radiología, Hospital Francisco de Borja, Gandía, Valencia, España.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Sanchez Aparisi
authors.affiliation: Servicio de Gastroenterología, Hospital Francisco de Borja, Gandía, Valencia, España.
authors.forename: Lidia
authors.initials: L
authors.lastname: Marti Gonzalez
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Francisco de Borja, Gandia, Valencia, España.
authors.forename: Federico
authors.initials: F
authors.lastname: Caro Martínez
mesh_terms: D001649:Bile Duct Diseases / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D001655:Bile Reflux / Q000150:complications* / Q000503:physiopathology; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D015994:Incidence; D007700:Kinetics; D008099:Liver / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies
keywords: Biliopancreatic reflux; Billiary pancreatitis; Liver function tests; Pancreatitis biliar; Pruebas funcionales hepáticas; Reflujo biliopancreatico