The timing of ERCP in acute biliary pancreatitis

Czech version

Authors: R. Svatoň ¹; Z. Kala ¹; I. Novotný ¹; J. Trna ^2,3; T. Andrašina ⁴; L. Kunovsky ^1,2
Authors‘ workplace: Chirurgická klinika Fakultní nemocnice Brno a Lékařské fakulty Masarykovy univerzity ¹; Interní gastroenterologická klinika Fakultní nemocnice Brno a Lékařské fakulty Masarykovy univerzity ²; Gastroenterologická ambulance, Interní oddělení, Nemocnice Boskovice ³; Klinika radiologie a nukleární medicíny Fakultní nemocnice Brno a Lékařské fakulty Masarykovy univerzity ⁴
Published in: Rozhl. Chir., 2019, roč. 98, č. 1, s. 10-13.
Category: Review

Overview

Despite several studies, the role and timing of endoscopic retrograde cholangiopancreatography (ERCP) in the case of acute biliary pancreatitis (ABP) remains a subject of discussion.There is a clear indication of early ERCP within 72 hours in patients with ABP andcholedochal obstruction, moreover the ERCP within 24 hours in cases of cholangitis. However, the role of ERCP in patients with ABP without symptoms of cholangitis or concrements obstructing the bile duct is controversial. If ABP is indicated for the ERCP, the earlier the ERCP is performed the less complications it is associated with. The decision to perform ERCP is often based on findings from a biochemical and transabdominal ultrasound examination. The results of these examinations may, but may not, confirm the presence of stones in the choledochus. An effective and safe method approaching the sensitivity of ERCP in the diagnosis of concrements in the choledochus is endoscopic ultrasonography (EUS) and magnetic resonance cholangiopancreatography (MRCP). The cholecystectomy should be performed to prevent a recurrence of pancreatitis and biliary problems after the successfully treatment of ABP.

Key words:

acute biliary pancreatitis − choledocholithiasis − cholangitis − endoscopic retrograde cholangiopancreatography

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Article was published in

Perspectives in Surgery

2019 Issue 1