[Acute biliary pancreatitis. Therapeutic approach]

Those forms of acute pancreatitis with a biliary etiology necessitate the choice of surgical techniques whose main objective is to obviate the cause of lithiasis and remove the necrotic and hemorrhagic areas of the gland. While probably overestimated from an epidemiological point of view, acute biliary pancreatitis still causes an overall mortality rate of 10% and has hardly been affected by the development of intensive care units and the routine use of somatostatin. By comparing the various approaches reported in the literature the Authors attempt to match the surgical concept of "timing" and the type of operation to be performed with the anatomopathological stage of disease. The paper reports the preliminary results of a treatment protocol in use since 1988 in group of 35 patients in whom the preoperative diagnosis of acute biliary pancreatitis was confirmed by computerised tomography.