Minimally invasive treatment of acute biliary pancreatitis

Surg Endosc. 1997 Dec;11(12):1179-82. doi: 10.1007/s004649900564.

Abstract

Background: Stones of the common bile duct are the most important factor in acute pancreatitis (AP). Endolaparoscopic surgery plays a well-recognized role in the treatment of this pathology.

Methods: From January 1992 to December 1995 we observed 62 cases of acute biliary pancreatitis (ABP). In 57 cases (= 93.4%) we proposed a minimally invasive treatment, based on performance of endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (ES) and then of laparoscopic cholecystectomy (LC).

Results: ERCP was attempted in emergency in 40/57 cases and successfully done in 34 cases. An ES was performed in all but two cases. In 51 patients we performed LC. The overall morbidity was 8. 9% with no mortality.

Conclusions: In the case of ABP early treatment can achieve the restoration of patency of the papilla, reducing the risk of associated cholangitis and the development of pancreatic necrosis. The cholecystectomy prevents the risk of relapse of ABP.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Ampulla of Vater / surgery
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects
  • Cholangitis / prevention & control
  • Cholecystectomy, Laparoscopic / adverse effects
  • Emergencies
  • Female
  • Gallstones / complications
  • Gallstones / surgery*
  • Humans
  • Laparoscopy* / adverse effects
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Necrosis
  • Pancreas / pathology
  • Pancreatitis / etiology
  • Pancreatitis / surgery*
  • Recurrence
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Factors
  • Sphincterotomy, Endoscopic / adverse effects
  • Survival Rate
  • Treatment Outcome