Acute biliary pancreatitis

Technological innovations in the past decade suggest that their systemic utilisation in acute biliary pancreatitis may have a significant impact on diagnosis and treatment. Urgent severity assessment resulting in the use of ERCP in patients with probable gallstones is essential since early endoscopic sphincterotomy may reduce morbidity and mortality. Contrast enhanced CT scanning is indispensable to the clinical decision-making process resulting in surgical intervention for necrosectomy. A rational application of diagnostic modalities, including ERCP, duodenal bile crystal analysis and dynamic biliary scanning, can greatly increase the proportion of patients with aetiological diagnosis, thereby enabling treatment to prevent further attacks. A fundamental knowledge of the patho-biochemical and patho-physiological nature of acute pancreatitis, however, is still required for further progress.