[Papillotomy in acute pancreatitis: more benefits than risks]

Area of Science:

• Gastroenterology and Hepatology
• Surgical Gastroenterology

Context:

• The exact causes of acute pancreatitis remain elusive.
• Opie's theory suggests Ampulla of Vater obstruction as a key etiological factor.
• The role of endoscopic papillotomy in managing acute pancreatitis is under ongoing investigation.

Purpose:

• To evaluate the efficacy of early endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic papillotomy in severe acute pancreatitis.
• To determine if endoscopic papillotomy reduces complications and hospitalization duration compared to conservative management.

Summary:

• Severe acute pancreatitis necessitates early ERCP to identify biliary origins.
• Endoscopic papillotomy is recommended upon detecting choledocholithiasis.
• This intervention demonstrated significant reductions in complication rates and hospital stays versus conservative treatment.

Impact:

• Findings support the use of endoscopic papillotomy in specific acute pancreatitis cases.
• Highlights the potential for improved patient outcomes and resource utilization.
• Underscores the need for controlled clinical trials to establish universal guidelines for endoscopic papillotomy in severe acute pancreatitis.