[Endoscopic therapy of biliary pancreatitis]

Gallstones are the most important causes of acute pancreatitis. Endoscopic-retrograde cholangiography (ERC) is indicated in all situations of acute pancreatitis where the cholestatic enzymes are elevated, the common bile duct is dilated or stones or sludge are detected in the gallbladder sonographically. Additional indications are cholecystectomized patients and where there is no evidence of heavy alcohol ingestion. If common bile duct stones are detected by ERC, endoscopic sphincterotomy is the treatment of choice. In severe cases of biliary pancreatitis in particular, endoscopic therapy improves the final outcome and reduces morbidity and mortality rates. The more severe the clinical situation, the earlier endoscopic therapy should be performed.