[Management of cholelithiasis associated with acute edematous pancreatitis]

The authors operated on fifty-four patients for gallstone disease associated with acute edematous pancreatitis in the years 1988-1993. The patients were operated on in the first admission, after the symptoms of pancreatitis had run their course and after normalization of amylase-concentration. Preoperative EST was successful in 7%. Depending on the results of routine intraoperative cholangiomanometry choledochotomy was carried out in 11% of the cases. There were no surgical technical difficulties in operations performed in the same admission. At the onset of pancreatitis the authors consider it right to apply one of the objective prognostic scoring systems suitable to predict the severity and prognosis of pancreatitis. Then, depending on its result and the risks of the planned intervention, ERCP-EST is proposed, leaving the gallbladder "in situ" and, either traditional, or laparoscopic cholecystectomy is also permissible.