[Acute biliary pancreatitis. Anatomoclinical and therapeutic aspects]

After an introduction on the role of the biliary factors in the etiopathogeny of acute pancreatitis the authors present an analysis of their personal experience in this field. A total of 46 cases are discussed, with acute biliary pancreatitis, which were diagnosed during surgical interventions. Of the 46 patients 13 had an oedematous form of acute biliary pancreatitis, 22 had necrotizing pancreatitis with associated haemorrhage, 3 had suppurated pancreatitis and 6 had a pancreatic abscess. In 6 patients the acute pancreatitis was either associated with, or triggered by acute non-lithiasic cholecystitis, and in 40 cases the acute pancreatitis was associated to biliary lithiasis. Surgery was performed as a result of inefficient intensive care, as an immediate emergency, in 56.42% of the cases, and as a late emergency (at 3-7 days) in 28% of the patients. Surgery was performed late in 14.71% of the cases. The surgical intervention was mainly directed to the treatment of the biliary lesions, and for the solving of pancreatic lesions, especially of the suppurative and necrotizing and haemorrhagic ones. The postoperative death rate was 34.7%, and death occurred in aged patients, in those with severe forms of pancreatitis of the haemorrhagic type, (8 cases), and with pancreatic suppurations (6 cases).