[Acute pancreatitis and cholelithiasis. A study of thirty cases (author's transl)]

The authors report a series of 30 cases of acute pancreatitis associated with cholelithiasis. There were 9 cases of necrotizing pancreatitis and the latter group included the 4 deaths observed in this series. Clinical, radiological and laboratory data were in favor of this association in 24 out of the 30 cases. Cholelithiasis appeared to be directly responsible for initiating the pancreatitis in 1/3 of cases. In another 1/3 of cases the mecanism was thought to be related to scarring of the sphincter of Oddi. In the remaining 1/3 of cases no direct relationship could be found. On the basis of these findings, the authors recommend that emergency surgery be reserved for these cases in which cholelithiasis appears to be the etiology. (The biliary syndrome overshadowing the pancreatic syndrome) and to postpone treatment of pancreatic lesions. In all other cases, the authors suggest to keep elective surgery, for after a period of initial conservative treatment with the hope of then treating together biliary and pancreatic lesions.