Endoscopic retrograde cholangiopancreatography in the investigation and management of patients after acute pancreatitis

Abstract

Thirty‐one patients who had been admitted with acute pancreatitis underwent endoscopic retrograde cholangiopancreatography (ERCP) following initial investigation by cholecystogram or intravenous cholangiogram and by biochemical screening. Previously undiagnosed gallstones were demonstrated at ERCP in 4 patients, and in 2 others known gallstones were effectively treated by endoscopic sphincterotomy. Changes of chronic pancreatitis were found in 8 pancreatograms and no patient in whom a normal pancreatic duct was demonstrated has suffered a further recurrence of acute pancreatitis. ERCP was valuable in the management of patients with acute pancreatitis, both in the diagnosis and management of biliary disease and in the recognition of underlying chronic pancreatitis.

Endoscopic Retrograde Cholangiopancreatography and Manometry Findings in 1,241 Idiopathic Pancreatitis Patients

“…Biliary stone disease was found in only 3.0% of our patients, which is lower than in earlier studies [7,12,13,32]. We expected to find a low frequency of biliary lesions in this series because patients with abnormal liver chemistries were excluded, the quality of noninvasive biliary imaging techniques continues to improve, and the threshold is lower for performing laparoscopic cholecystectomy.…”

Evaluation of Unexplained Acute and Acute Recurrent Pancreatitis Using Endoscopic Retrograde Cholangiopancreatography, Sphincter of Oddi Manometry and Endoscopic Ultrasound

“…Its utility in the evaluation of pancreatitis was first described by Cotton & Beales in 1974 [23]. ERCP is effective in revealing many previously undetected causes, including unsuspected cholelithiasis [5,24,25], papillary stenosis [2,3,25], and pancreas divisum [23, 26 -28]. In one large ERCP series, Venu et al studied 116 patients with idiopathic recurrent pancreatitis and negative transabdominal ultrasound Original Article [3].…”

Idiopathic Acute Pancreatitis and Sphincter of Oddi Dysfunction: Diagnostic and Therapeutic Role of ERCP and Sphincter of Oddi Manometry

“…ERCP may identify the underlying etiology for iRAP in 38-79 % of cases; however, this is based on older studies before the routine use of MRCP and EUS. The diagnostic yield varies widely depending on whether the gallbladder is intact [15,20,34,[60][61][62][63][64]. The likelihood of occult choledocholithiasis or microlithiasis (biliary crystals) is highest in patients with an intact gallbladder (50 %) compared to nearly none in patients post-cholecystectomy [20,64], and structural abnormalities such as obstructing tumors and pancreas divisum are more likely in older (age > 60) individuals [15].…”