Biliary pancreatitis: Clinical presentation and surgical management

Frei, Gary J.; Frei, Victoria T.; Thirlby, Richard C.; McClelland, Robert N.

doi:10.1016/0002-9610(86)90028-0

Cited by 79 publications

(46 citation statements)

References 7 publications

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“…Upon reviewing the studies that have assessed recurrence, we came across conflicting figures oscillating between 3% (23) and 61% (24). Obviously, the reasons recorded for cholecystectomy also vary.…”

Section: Discussionmentioning

confidence: 99%

“…There are studies that identify no risk factors for recurrence, and then studies that relate AP recurrence to gallstone size (7), episode severity (8), early reintroduction of food, biochemical changes in liver function, age, or race (9). However, the incidence of AGP recurrence and the time to recurrence are highly variable in reported series (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources

et al. 2016

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Introduction: Acute pancreatitis is often a relapsing condition, particularly when its triggering factor persists. Our goal is to determine the recurrence rate of acute biliary pancreatitis after an initial episode, and the time to relapse, as well as to identify the risk factors for recurrence. Material and method:We included all patients admitted for a first acute gallstone pancreatitis event during four years. Primary endpoints included readmission for recurrence and time to relapse.Results: We included 296 patients admitted on a total of 386 occasions. The incidence of acute biliary pancreatitis in our setting is 17.5/100,000 population/year. In all, 19.6% of pancreatitis were severe (22.6% of severe acute pancreatitis for first episodes versus 3.6% for recurring pancreatitis), with an overall mortality of 4.4%. Overall recurrence rate was 15.5%, with a median time to relapse of 82 days. In total, 14.2% of patients relapsed after an acute pancreatitis event without cholecystectomy or endoscopic retrograde cholangio-pancreatography. Severe acute pancreatitis recur in 7.2% of patients, whereas mild cases do so in 16.3%, this being the only risk factor for recurrence thus far identified.Conclusions: Patients admitted for pancreatitis should undergo cholecystectomy as soon as possible or be guaranteed priority on the waiting list. Otherwise, endoscopic retrograde cholangio-pancreatography with sphincterotomy may be an alternative to surgery for selected patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources

et al. 2016

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“…The evidence that does exist originates mainly from older retrospective studies that observed no recurrent ABP after a cholecystectomy compared with a 25% to 61% rate of ABP recurrence with conservative management [11][12][13][14][15][16][17]. From a retrospective population-based cohort study, it was concluded that a cholecystectomy reduces the risk of a recurrent or de novo ABP almost to the same level as found in the general population [18].…”

Section: Cholecystectomy Versus Conservative Treatmentmentioning

confidence: 99%

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

et al. 2009

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Background Recurrent attacks of acute biliary pancreatitis (RABP) are prevented by (laparoscopic) cholecystectomy. Since the introduction of endoscopic retrograde cholangiopancreaticography (ERCP), several series have described a similar reduction of RABP after endoscopic sphincterotomy (ES). This report discusses the different treatment options for preventing RABP including conservative treatment, cholecystectomy, ES, and combinations of these options as well as their respective timing. Methods A search in PubMed for observational studies and clinical (comparative) trials published in the English language was performed on the subject of recurrent acute biliary pancreatitis and other gallstone complications after an initial attack of acute pancreatitis. Result Cholecystectomy and ES both are superior to conservative treatment in reducing the incidence of RABP. Cholecystectomy provides additional protection for gallstone-related complications and mortality. Observational studies indicate that cholecystectomy combined with ES is the most effective treatment for reducing the incidence of RABP attacks.Conclusion From the literature data it can be concluded that ES is as effective in reducing RABP as cholecystectomy but inferior in reducing mortality and overall morbidity. The combination of ES and cholecystectomy seems superior to either of the treatment methods alone. A prospective randomized clinical trial comparing ES plus cholecystectomy with cholecystectomy alone is needed.Keywords Acute biliary pancreatitis Á Cholecystectomy Á Endoscopic sphincterotomy Á ERCP Á Recurrent Acute biliary or gallstone pancreatitis (ABP) is an inflammatory condition of the pancreas induced by gallstones [1]. The initial treatment of ABP can be either conservative or interventional. The coexistence of cholangitis is an accepted indication for the performance of endoscopic retrograde cholangiopancreaticography (ERCP). However, whether this procedure is performed for patients with ABP depends on local expertise and guidelines, as is the decision to perform an endoscopic sphincterotomy (ES) [2][3][4][5].After patients have recovered from their first attack of ABP, most guidelines advocate a cholecystectomy to prevent a recurrent attack or other gallstone-related disorders such as symptomatic choledocholithiasis, cholecystitis, gallstone ileus, jaundice, and cholangitis [2][3][4][5]. ''Recurrent'' symptomatic choledocholithiasis after an initial attack of ABP may be preexisting common bile duct (CBD) stones not detected at the time of the primo episode or stones that migrated from the gallbladder into the CBD after initial stone clearance. Choledocholithiasis also may have developed newly within the bile duct after cholecystectomy.

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“…Frei ve ark. [13] rekürrenslerin %52.1'ini, AP atağından sonraki ilk 6 hafta içinde gözledi. İlgili çalışmada, tekrarlayan atakların %90'ı safra kesesi mevcut olan hastalarda görüldü.…”

Section: Discussionunclassified

Rekürren biliyer pankreatit nasıl önlenebilir? Olgu sunumu ve literatür derlemesi.

Başak¹,

Tardu²,

Sevinç³

et al. 2016

Archives of Clinical and Experimental Medicine

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Biliary pancreatitis: Clinical presentation and surgical management

Cited by 79 publications

References 7 publications

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence. Consequences of lack of resources

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

Rekürren biliyer pankreatit nasıl önlenebilir? Olgu sunumu ve literatür derlemesi.

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