Endoscopic Treatment of Biliary Acute Pancreatitis

  • D. L. Carr-Locke
Conference paper


Gallstones and alcohol represent the most common etiologic factors associated with over 80% of the cases of acute pancreatitis. There is an extensive list of other associated conditions (see Table 1), with approximately 10% of cases falling into the idiopathic category if a thorough investigation is carried out [1–4]. Gallstones are the most common single cause of acute pancreatitis in the United Kingdom [2, 5–7] and in certain parts of North America [8–10],


Acute Pancreatitis Pancreatic Duct Common Bile Duct Stone Endoscopic Sphincterotomy Gallstone Pancreatitis 
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.
    Steer ML (1989) Classification and pathogenesis of pancreatitis. Surg Clin North Am 69:467–480PubMedGoogle Scholar
  2. 2.
    Goodman AJ, Neoptolemos JP, Carr-Locke DL et al. (1985) Detection of gallstones after acute pancreatitis. Gut 26:125–132PubMedCrossRefGoogle Scholar
  3. 3.
    Corfield AP, Cooper MJ, Williamson RCN (1985) Prediction of severity in acute pancreatitis: a prospective comparison of the prognostic indices. Lancet 2:403–407PubMedCrossRefGoogle Scholar
  4. 4.
    Ranson JHC (1982) Etiologic and prognostic factors in human acute pancreatitis: a review. Am J Gastroenterol 77:633–638PubMedGoogle Scholar
  5. 5.
    Blarney SL, Imrie CW, O’Neill J et al. (1984) Prognostic factors in acute pancreatitis. Gut 25:1340–1346CrossRefGoogle Scholar
  6. 6.
    Corfield AP, Cooper MJ, Williamson RCN (1985) Acute pancreatitis: a lethal disease of increasing incidence. Gut 26:724–729PubMedCrossRefGoogle Scholar
  7. 7.
    MRC Multicentre Trial (1977) Death from acute pancreatitis. Lancet 2:632–635Google Scholar
  8. 8.
    Kelly TR (1980) Gallstone pancreatitis. The timing of surgery. Surgery 88: 345–349PubMedGoogle Scholar
  9. 9.
    Acosta JM, Peligrini CA, Skinner DB (1980) Etiology and pathogenesis of acute biliary pancreatitis. Surgery 88:118–125PubMedGoogle Scholar
  10. 10.
    Dixon JA, Hillam JD (1970) Surgery treatment of biliary tract disease associated with acute pancreatitis. Am J Surg 120:371–375PubMedGoogle Scholar
  11. 11.
    Frey CF, Bradley EL III, Beger HG (1988) Progress in acute pancreatitis. Surg Gynecol Obstet 167:282–286PubMedGoogle Scholar
  12. 12.
    van Sonnenberg E, Casola G, Varney RR et al. (1989) Imaging and interventional radiology for pancreatitis and its complications. Radiol Clin North Am 27:65–72Google Scholar
  13. 13.
    Steiner E, Mueller PR, Hahn PF et al. (1988) Complicated pancreatic abscesses: problems in interventional management. Radiology 167:443–446PubMedGoogle Scholar
  14. 14.
    Ranson JHC, Balthazar E, Caccavale R et al. (1985) Computed tomography and the prediction of pancreatic abscess in acute pancreatitis. Ann Surg 201:656–665PubMedCrossRefGoogle Scholar
  15. 15.
    Opie EL (1901) The etiology of acute hemorrhagic pancreatitis. Johns Hopkins Hosp Bull 121:182–188Google Scholar
  16. 16.
    Cuschieri A, Hughes JH (1973) Pancreatic reflux during operative choledochography. Br J Surg 60:933–936PubMedCrossRefGoogle Scholar
  17. 17.
    Kelly TR (1976) Gallstone pancreatitis: pathophysiology. Surgery 80:488–492PubMedGoogle Scholar
  18. 18.
    Armstrong CP, Taylor TV, Jeacock J et al. (1985) The biliary tract in patients with acute gallstone pancreatitis. Br J Surg 72:551–555PubMedCrossRefGoogle Scholar
  19. 19.
    Acosta JM, Ledesma CL (1974) Gallstone migration as a cause of acute pancreatitis. N Engl J Med 290:484–487PubMedCrossRefGoogle Scholar
  20. 20.
    Kelly TR, Swaney PE (1982) Gallstone pancreatitis: the second time around. Surgery 92:571–575PubMedGoogle Scholar
  21. 21.
    Stone HH, Fabian TC, Dunlop WE (1981) Gallstone pancreatitis: biliary tract pathology in relation to time of operation. Ann Surg 194:305–310PubMedCrossRefGoogle Scholar
  22. 22.
    Paloyan D, Simonowitz D, Skinner DB (1975) The timing of biliary tract operations in patients with pancreatitis associated with gallstones. Surg Gynecol Obstet 141:737–739PubMedGoogle Scholar
  23. 23.
    Ranson JHC (1979) The timing of biliary surgery in acute pancreatitis. Ann Surg 189:654–662PubMedCrossRefGoogle Scholar
  24. 24.
    Cuschieri A, Cumming JGR, Wood RAB et al. (1983) Evidence for sphincter dysfunction in patients with gallstone-associated pancreatitis. Effect of ceruletide in patients undergoing cholecystectomy for gallbladder disease and gallstone- associated pancreatitis. Br J Surg 71:885–888CrossRefGoogle Scholar
  25. 25.
    Mayer AD, McMahon MJ, Benson EA et al. (1984) Operations upon the biliary tract in patients with acute pancreatitis: aims, indications and timing. Ann R Coll Surg Engl 66:179–183PubMedGoogle Scholar
  26. 26.
    DeBolla AR, Obeid ML (1984) Mortality in acute pancreatitis. Ann R Coll Surg Engl 66:184–186Google Scholar
  27. 27.
    Imrie CW, Banjamin IS, Ferguson JC (1978) A single-centre double-blind trial of Trasyol therapy in primary acute pancreatitis. Br J Surg 65:337–641PubMedCrossRefGoogle Scholar
  28. 28.
    Obsorne DH, Imrie CW, Carter DC (1981) Biliary surgery in the same admission for gallstone-associated acute pancreatitis. Br J Surg 68:758–761CrossRefGoogle Scholar
  29. 29.
    Leese T, Shaw D (1988) Comparison of three Glasgow multifactor prognostic scoring systems in acute pancreatitis. Br J Surg 75:460–462PubMedCrossRefGoogle Scholar
  30. 30.
    Williamson RCN (1984) Early assessment of severity in acute pancreatitis. Gut 25:1331–1339PubMedCrossRefGoogle Scholar
  31. 31.
    Beger HG, Bittner R, Block S et al. (1986) Bacterial contamination of pancreatic necrosis. A prospective clinical study. Gastroenterology 91:433–438PubMedGoogle Scholar
  32. 32.
    Neoptolemos JP, Hall AW, Finlay DF et al. (1984) The urgent diagnosis of gallstones in acute pancreatitis: a prospective study of three methods. Br J Surg 71:230–233PubMedCrossRefGoogle Scholar
  33. 33.
    Neoptolemos JP, Fossard DP, Berry JM (1983) A prospective study of radionuclide biliary scanning in acute pancreatitis. Ann R Coll Surg Engl 65:180–182PubMedGoogle Scholar
  34. 34.
    Neoptolemos JP, London N, Bailey I et al. (1987) The role of clinical and biochemical criteria and endoscopic retrograde cholangiopancreatography in the urgent diagnosis of common bile duct stones in acute pancreatitis. Surgery 100:732–742Google Scholar
  35. 35.
    Tondelli P, Stutz K, Harder F et al. (1982) Acute gallstone pancreatitis: best timing for biliary surgery. Br J Surg 69:709–710PubMedCrossRefGoogle Scholar
  36. 36.
    Fan ST, Choi TK, Lai CS et al. (1988) Influence of age on the mortality from acute pancreatitis. Br J Surg 75:463–466PubMedCrossRefGoogle Scholar
  37. 37.
    Ranson JHC (1990) The role of surgery in the management of acute pancreatitis. Ann Surg 211:382–393PubMedCrossRefGoogle Scholar
  38. 38.
    Acosta JM, Rossi R, Galli OMR et al. (1978) Early surgery for acute gallstone pancreatitis: evaluation of a systematic approach. Surgery 83:367–370PubMedGoogle Scholar
  39. 39.
    Kelly TR, Wagner DS (1988) Gallstone pancreatitis: a prospective randomized trial of the timing of surgery. Surgery 104:600–605PubMedGoogle Scholar
  40. 40.
    Roesch W, Demling L (1982) Endoscopic management of pancreatitis. Surg Clin North Am 62:845–852PubMedGoogle Scholar
  41. 41.
    Classen M, Ossenberg W, Wurbs D et al. (1978) Pancreatitis: an indication for endoscopic papillotomy? Endoscopy 10:223 (abstr)Google Scholar
  42. 42.
    Van Spuy DS (1981) Endoscopic sphincterotomy in the management of gallstone pancreatitis. Endoscopy 13:25–26PubMedCrossRefGoogle Scholar
  43. 43.
    Safrany L (1982) Controversies in acute pancreatitis. In: Hollender LF (ed) Controversies in acute pancreatitis. Springer, Berlin Heidelberg New York, pp 214–218CrossRefGoogle Scholar
  44. 44.
    Schott B, Neuhaus B, Portacarrero G et al. (1982) Endoskopische Papillotomie bei akuter bilaren Pankreatitis. Klinikarzt 11:52–54Google Scholar
  45. 45.
    Kautz G, Kohaus H, Keferstein R-D et al. (1982) Zur Pathogenese und endoskopischen Therapie der akuten bilaren Pankreatitis. Klinikarzt 11: 1202–1212Google Scholar
  46. 46.
    Riemann von JF, Lux G (1984) Therapeutische Strategie bei der akuten Pankreatitis. 1. Fortschr Med 102:179–182PubMedGoogle Scholar
  47. 47.
    Rosseland AR, Solhaug JH (1984) Early or delayed endoscopic papillotomy (EPT) in gallstone pancreatitis. Ann Surg 199:165–167PubMedCrossRefGoogle Scholar
  48. 48.
    Neoptolemos JP, London N, Slater ND et al. (1986) A prospective study of ERCP and endoscopic sphincterotomy in the diagnosis and treatment of gallstone acute pancreatitis. Arch Surg 121:697–702PubMedGoogle Scholar
  49. 49.
    Neoptolemos JP, Carr-Locke DL, London NJ (1988) Controlled trial or urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet 2:979–983PubMedCrossRefGoogle Scholar
  50. 50.
    Neoptolemos JP, Davidson BR, Vallance D et al. (1988) The role of duodenal bile crystal analysis in the investigation of “idiopathic” pancreatitis. Br J Surg 75:450–453PubMedCrossRefGoogle Scholar
  51. 51.
    Neoptolemos JP (1988) The urgent diagnosis and treatment of biliary (gallstone associated) acute pancreatitis. Hunterian Lecture: Royal College of Surgeons of England, London, SeptemberGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • D. L. Carr-Locke
    • 1
  1. 1.Dept. of EndoscopyBrigham and Women’s HospitalBostonUSA

Personalised recommendations