[Endoscopic sphincterotomy in acute biliary pancreatitis]

Six patients, 4 females and 2 males, mean age 58 (range 30-75) underwent an early endoscopic sphincterotomy because of acute pancreatitis. Serum amylases were 8N in 4 patients and greater than 20N in 2 cases. Ranson's criteria average was 2.2 for each patient. Ultrasonography showed gallbladder stones in 4 patients (2 patients underwent previously a cholecystectomy), choledochal stones in 1 patient, dilatation of main bile duct in 2 patients. Meteorism hid bile duct in 3 cases and pancreas in 5 cases. Duodenoscopy showed: papilla obstructed by gallstones in 2 patients, bulging intramural common bile duct in 2 patients; outlet of microstones and pus from papilla in 1 patient and in 1 case outlet of pus from papilla. Papillary obstruction was due to impacted stones in 4 patients, microstones in 1 patient and benign papillary stenosis in 1 patient. We performed standard sphincterotomy 3 times and in 3 patients we had to perform infundibolotomy. After endoscopic sphincterotomy and stones extraction, all the patients improved quickly and biochemical signs become normal in few days. We must not report any complication.