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[Cholelithiasis and acute pancreatitis].

G P Dzieniszewski, M Neher, H D Schmidt

    Deutsche Medizinische Wochenschrift (1946)
    |September 7, 1984
    PubMed
    Summary

    In acute biliary pancreatitis, inflammation, not gallstones, is the primary issue. Early intervention for impacted stones is key, while other surgeries depend on pancreatitis severity.

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    Area of Science:

    • Gastroenterology
    • Surgical Pathology

    Background:

    • Cholelithiasis (gallstones) can lead to biliary pancreatitis.
    • Distinguishing between associated pancreatitis and primary biliary pancreatitis is crucial for management.

    Purpose of the Study:

    • To compare the characteristics and outcomes of patients with cholelithiasis and "associated pancreatitis" versus those with "acute pancreatitis of biliary origin".

    Main Methods:

    • Retrospective analysis of 2161 patients with cholelithiasis (1972-1983).
    • Comparison of patient groups based on clinical history, intra-operative findings, and treatment outcomes.
    • Specific focus on the incidence of choledocholithiasis and impacted papillary concrements.

    Main Results:

    • 21% of cholelithiasis patients had choledochal stones; 5.6% had "associated pancreatitis" based on comprehensive findings.
    • Choledocholithiasis incidence was similar (36-39%) in both "associated pancreatitis" and "acute pancreatitis of biliary origin" groups.
    • Impacted papillary concrements were more frequent in "associated pancreatitis" (7.4%) than in primary biliary pancreatitis (2.9%) groups.

    Conclusions:

    • Acute inflammatory pancreatitis dominates the clinical picture in biliary pancreatitis.
    • Early endoscopic intervention is recommended for impacted papillary stones.
    • Surgical timing for other procedures is dictated by the severity and progression of acute pancreatitis.

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