Related Experiment Videos
Beneficial effects of ERCP and papillotomy in predicted severe biliary pancreatitis
M G H Besselink1, L P van Minnen, K J van Erpecum
1Department of Surgery, University Medical Center Utrecht, The Netherlands.
Background/Aims:
Extensive circumstantial evidence indicates that patients with a predicted severe attack of acute biliary pancreatitis (ABP) should undergo an endoscopic retrograde cholangiography with papillotomy (ERC/PT). However, in clinical practice this procedure is not always performed. This study was conducted to compare outcome in patients with and without ERC/PT.
Methodology:
Thirty-five of 80 patients admitted with ABP had a predicted severe attack (three or more Ranson criteria). Only in 24 of these 35 patients was an ERC/PT performed.
Results:
In the ERC/PT group, significantly less pancreatic necrosis (8 vs. 64%, p<0.001) occurred, hospital stay was shorter (median 22 +/- 5 vs. 51 +/- 19 days, P=0.08) and mortality was lower (8 vs. 36%, P=0.01). Twenty-three patients (66%) underwent cholecystectomy after a median period of 10 weeks (range 0-26 weeks) after discharge. During the waiting period, in the ERC/PT group, two patients developed acute cholecystitis whereas recurrent ABP and common bile duct stones occurred in one patient each.
Conclusions:
In patients with a predicted severe attack of ABP, performing ERC/PT is associated with less morbidity and lower mortality.
Related Concept Videos
01:26Endoscopic Procedures V: ERCP
Patient...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:25Acute Pancreatitis I: Introduction
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...