Acute Biliary Pancreatitis

  • P. Malfertheiner
Conference paper


Gallstones are a well established pathogenetic factor in acute pancreatitis and recognized as one of its two major causes. While alcohol has a higher prevalence among cases with acute pancreatitis reported in series from North America [1] and Germany [2], gallstones are the commonest etiological factor of acute pancreatitis in the United Kingdom, where they account for more than 50% of cases [3]. No definite explanation is available for these geographic discrepancies.


Acute Pancreatitis Common Bile Duct Pancreatic Duct Common Bile Duct Stone Endoscopic Sphincterotomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ranson JHC (1982) Etiological and prognostic factors in human acute pancreatitis: a review. Am J Gastroenterol 77: 633–638PubMedGoogle Scholar
  2. 2.
    Goebell H, Hotz J (1976) Die Ätiologie der akuten Pankreatitis. In: Forell MM (ed) Handbuch der Inneren Medizin, vol 6: Pankreas. Springer, Berlin Heidelberg New York, pp 615–675Google Scholar
  3. 3.
    Corfield AP, Cooper MJ, Williamson RCN (1985) Acute pancreatitis: a lethal disease of increasing incidence. Gut 26: 724–729PubMedCrossRefGoogle Scholar
  4. 4.
    Moreau JA, Zinsmeister AR, Melton LJ, DiMagno EP (1988) Gallstone pancreatitis and the effect of cholecystectomy: a population-based cohort study. Mayo Clin Proc : 466–473PubMedGoogle Scholar
  5. 5.
    Opie EL (1901) The etiology of acute hemorrhagic pancreatitis. Bull Johns Hopkins Hosp 12: 182–188Google Scholar
  6. 6.
    Acosta JM, Ledesma CL (1974) Gallstone migration as a cause of acute pancreatitis. N Engl J Med 290: 484–488PubMedCrossRefGoogle Scholar
  7. 7.
    Kelly TR (1976) Gallstone pancreatitis: pathophysiology. Surgery 80: 488–492PubMedGoogle Scholar
  8. 8.
    Mayer AD, McMahon MJ, Benson EA, Axon ATR (1984) Operations upon the biliary tract in patients with acute pancreatitis: aims, indications and timing. Ann R Coll Surg Eng 66: 179–183Google Scholar
  9. 9.
    Reber HA, Farmer RC, Maslin SC (1982) Effects of bile on the permeability of the pancreatic duct to macromolecules. Gastroenterology 82: 1156Google Scholar
  10. 10.
    Steer ML (1986) Etiology and pathophysiology of acute pancreatitis. In: Go VLW (ed) The exocrine pancreas: biology, pathobiology, and diseases. Raven, New York, pp 465–474Google Scholar
  11. 11.
    Steer ML, Meldolesi J, Figarella C (1984) Pancreatitis. The role of lysosomes. Dig Dis Sci 29: 934–938PubMedCrossRefGoogle Scholar
  12. 12.
    McMahon MJ, Shetta JR (1980) Physical characteristics of gallstones and the calibre of the cystic duct in patients with acute pancreatitis. Br J Surg 67: 6–9PubMedCrossRefGoogle Scholar
  13. 13.
    Armstrong CP, Tylor TV, Jeacock J, Lucas S (1985) The biliary tract in patients with acute gallstone pancreatitis. Br J Surg 72: 551–555PubMedCrossRefGoogle Scholar
  14. 14.
    Houssin D, Castaing D, Lemoine J, Bismuth H (1983) Microlithiasis of the gallbladder. Surg Gynecol Obstet 157: 20–24PubMedGoogle Scholar
  15. 15.
    Armstrong CP, Taylor TV (1986) Pancreatic-duct reflux and acute gallstone pancreatitis. Ann Surg 204: 59–64PubMedCrossRefGoogle Scholar
  16. 16.
    Creutzfeldt W, Lankisch PG (1985) Acute pancreatitis: etiology and pathogenesis. In: Berk JE (ed) Bockus Gastroenterology, vol. 6, 4th edn. Saunders, Philadelphia, pp 3971–3992Google Scholar
  17. 17.
    Imrie CW (1987) Gallstone-associated acute pancreatitis. In: Beger HG, Büchler M (eds) Acute pancreatitis. Springer, Berlin Heidelberg New York, pp 227–232Google Scholar
  18. 18.
    Malfertheiner P, Biichler M (1987) Clinical symptoms and signs and diagnostic requirements in acute pancreatitis. In: Beger HG, Biichler M (eds) Acute pancreatitis. Springer, Berlin Heidelberg New York, pp 103–109Google Scholar
  19. 19.
    McMahon MJ, Mayer AD (1984) Comparison of the clinical features of acute pancreatitis due to gallstones and alcohol. In: Gyr KE, Singer MV, Sarles H (eds) Pancreatitis — concepts and classification. Elsevier, Amsterdam, pp 379–388Google Scholar
  20. 20.
    Lankisch PG (1988) Aetiology of acute pancreatitis. In: Glazer G, Ranson JHC (eds) Acute pancreatitis: experimental and clinical aspects of pathogenesis and management. Bailliere Tindall, Eastbourne, pp 167–181Google Scholar
  21. 21.
    Blarney SL, Osborne DH, Gilmour WH, O’Neill J, Carter DC, Imrie CW (1983) The early identification of patients with gallstone-associated pancreatitis using clinical and biochemical factors only. Ann Surg 198: 514–518Google Scholar
  22. 22.
    Mayer AD, McMahon MJ (1985) Biochemical identification of patients with gallstones associated acute pancreatitis on the day of admission to hospital. Ann Surg 201: 68–75PubMedGoogle Scholar
  23. 23.
    Uhl W, Biichler M, Malfertheiner P, Beger HG (1988) Severity of acute pancreatitis is unrelated to the etiology. Digestion XX Meeting of the European Pancreatic Club 6: 120Google Scholar
  24. 24.
    Beger HG, Block S, Bittner R (1987) The significance of bacterial infection in acute pancreatitis. In: Beger HG, Biichler M (eds) Acute pancreatitis. Springer, Berlin Heidelberg New York, pp 79–86Google Scholar
  25. 25.
    Biichler M, Uhl W, Malfertheiner P (1987) Biochemical staging of acute pancreatitis. In: Beger HG, Biichler M (eds) Acute pancreatitis. Springer, Berlin Heidelberg New York, pp 143–153Google Scholar
  26. 26.
    Kelly TR (1980) Gallstone pancreatitis: the timing of surgery. Surgery 38: 345–350Google Scholar
  27. 27.
    Kelly TR, Swaney PE (1982) Gallstone pancreatitis: second time around. Surgery 92: 571–574PubMedGoogle Scholar
  28. 28.
    Acosta JM, Rossi R, Galli DM (1978) Early surgery for acute gallstone pancreatitis: evaluation of a systemic approach. Surgery 83: 367–371PubMedGoogle Scholar
  29. 29.
    Stone HH, Fabian TC, Dunlop EW (1981) Gallstone pancreatitis, biliary tract pathology in relation to time of operation. Ann Surg 194: 305–312PubMedCrossRefGoogle Scholar
  30. 30.
    Kelly TR, Wagner DS (1988) Gallstone pancreatitis: a prospective randomized trial of the timing of surgery. Surgery 104: 600–605PubMedGoogle Scholar
  31. 31.
    Frei GJ, Frei VT, Thirlby RC, McClelland RN (1986) Biliary pancreatitis: clinical presentation and surgical management. Am J Surg 151: 170–175PubMedCrossRefGoogle Scholar
  32. 32.
    Van Spuy DS (1981) Endoscopic sphincterotomy in the managment of gallstone pancreatitis. Endoscopy 13: 25–26PubMedCrossRefGoogle Scholar
  33. 33.
    Safrany L (1982) Controversies in acute pancreatitis. Springer, Berlin Heidelberg New York, pp 214–218CrossRefGoogle Scholar
  34. 34.
    Neoptolemos JP, Carr-Locke DL, London NJ, Bailey I A, James D, Fossard DP (1988) Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet ii: 979–983Google Scholar

Copyright information

© Springer-Verlag, Berlin Heidelberg 1990

Authors and Affiliations

  • P. Malfertheiner
    • 1
  1. 1.Department of Internal Medicine IIUniversity of UlmUlmGermany

Personalised recommendations