Lito impactado en la papila duodenal como factor de riesgo en enfermedad pancreatobiliar

Abstract

An impacted bile duct stone at duodenal papilla or impacted papillary stone (IPS) is an infrequent presentation of choledocholitiasis. It is unknown if the IPS is a risk factor for acute cholangitis (AC) or acute pancreatitis (AP). We performed a retrospective case-control study comparing patients with IPS and patients with choledocholithiasis during endoscopic retrograde cholangiopancreatography (ERCP). We included 363 patients with choledocholithiasis during ERCP. Thirty-one patients presented IPS during the ERCP. The mean age was 46 years (range 14-89 years), six patients had cholecystectomy background, and 24 cases were female. AC was observed in 15 cases and AP was diagnosed in nine patients. The association between IPS was significant on the AC group odds ratio 4.14, p < 0.01, but not significant on the AP group. IPS is a risk factor to develop AC. Endoscopic stone removal should be performed.