Selective Management of Patients with Acute Biliary Pancreatitis

Telem, Dana A.; Bowman, Kimberly; Hwang, John S.; Chin, Edward; Nguyen, Scott Q.; Divino, Celia M.

doi:10.1007/s11605-009-1041-1

Cited by 19 publications

(19 citation statements)

References 23 publications

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“…We used the same 5 quantitative variables and their cutoffs as determined by the original study to determine the score. 11 We modified the proposed treatment protocol slightly. Scores of 0 and 5 were unchanged.…”

Section: Methodsmentioning

confidence: 99%

“…11 Using retrospective data and multivariate analysis, it determined 5 quantitative variables and their cutoffs that have a positive predictive value (PPV) for CBD stones: CBD size $ 9 mm, gamma glutamyl transferase (GGT) $ 350 U/L, alkaline phosphatase (AP) $ 250 U/L, total bilirubin (TB) $ 3 mg/ dL, and direct bilirubin (DB) $ 2 mg/dL. 11 All 5 values were determined at the time of admission. One point was given for each criterion met.…”

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confidence: 99%

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Validation and improvement of a proposed scoring system to detect retained common bile duct stones in gallstone pancreatitis

Sherman

Shi

Ranasinghe

et al. 2015

Surgery

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Validation and improvement of a proposed scoring system to detect retained common bile duct stones in gallstone pancreatitis

Sherman

Shi

Ranasinghe

et al. 2015

Surgery

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“…Comparable result was observed regarding the age-gender characteristics of the current study subjects where mean age of the study subjects was 35.48 (± 14.59) and their age ranged from 20 to 63 years. Researchers found that 30-75% of all cases of acute pancreatitis were due to gallstone, more than 30% of pancreatitis cases were due to complications of heavy alcohol abuse, 25% of pancreatitis was due to hypertriglyceridaemia, 15% due to post ERCP procedure and 10-30% was idiopathic 10 . In present study it was seen that acute pancreatitis was associated with hypertriglyceridemia (19.79%), gall stone (12.5%), post ERCP (6.25%) and alcoholism (2.08%).…”

Section: Discussionmentioning

confidence: 99%

Role of Computed Tomography In The Evaluation of Severity of Acute Pancreatitis

Sharif¹,

Ferdousi

Rahman

et al. 2017

KYAMC j.

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Title: Role of computed tomography in the evaluation of severity of acute pancreatitis.Introduction: Early diagnosis and determination of severity of acute pancreatitis is important for management and it depends largely on severity of disease. Medical treatment of mild acute pancreatitis includes conservative management while severe acute pancreatitis requires intensive care to surgical intervention (open or minimally invasive) in selected cases.Methodology: This prospective study was carried out to find out the correlation between modified CT severity index and patient's clinical outcome in acute pancreatitis enrolling 96 subjects in the department of Radiology and Imaging, BIRDEM during two years time period. Severity of acute pancreatitis was assessed by both clinical and imaging staging (Modified CT severity index) in mild, moderate and severe groups.Result: Mean age ( ± SD) of the study subjects was 35.48 ± 14.59 years and number of male was 60 (62.50%) and female was 36 (37.50%). Acute pancreatitis was associated with hypertriglyceridemia (19.79%), gall stone (12.5%), post ERCP (6.25%) and alcoholism (2.08%). Aetiology was unidentified in 59.73% subjects. Majority of the subjects with acute pancreatitis presented with abdominal pain, fever (20.08%), vomiting (54.41%) and oedema (25%). On imaging, diffuse pancreatic enlargement was noted in 29.16% subjects. Pancreatic inflammation with and without peripancreatic fat involvement were observed in 27.08% and 72.91% subjects respectively. Pseudocyst formation (13.54%), ascites (30.20%), renal fascia involvement (46.87%) and pleural effusion (37.5%) were seen in CT scan. Severity of acute pancreatitis was evaluated by clinical findings and CT severity index and the measure of agreement between clinical and imaging staging was almost perfect. CT severity index in acute pancreatitis had statically significant relation with clinical outcome (0.573), organ failure (0.674), need for surgical intervention (0.463) and hospital stay (0.235).Conclusion: Modified CT severity index in acute pancreatitis correlates with patient outcome. During reporting if this simple scoring system is applied then we can easily measure the severity and determine whether patient need medical or surgical intervention.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 738-744

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“…Various studies have tried to identify variables in patients presenting with ABP which can reliably predict CBD stones. Telem et al 17 felt that grouping significant predictors as opposed to individual values, would increase reliability of detection. They found that increased CBD size on initial ultrasound, increased alkaline phosphatase, total bilirubin, direct bilirubin, gamma glutamyl transferase significantly correlated with presence of persistent stone.…”

Section: Methodsmentioning

confidence: 99%

Presence of choledocholithiasis in patients undergoing cholecystectomy for mild biliary pancreatitis

Pradhan

Shah

2016

Bangladesh J Med Sci

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Background: Standard recommendations for patients recovering from an episode of biliary pancreatitis include cholecystectomy with intra operative cholangiogram or ERCP during the same hospital admission as it is believed that the instigating factor is the passage of stones through the common bile duct. As ERCP is not widely available and expensive, cholecystectomy with IOC is routinely performed to rule out choledocholithiasis. However detection of common bile duct stones is challenging. Whether these patients undergoing cholecystectomy require direct common bile duct evaluation is controversial. Objectives: To see the presence of common bile duct stones in patients with resolving acute mild biliary pancreatitis. Materials and Methods: Patients admitted in the surgical ward in Patan and Bir hospital with the diagnosis of mild acute biliary pancreatitis that underwent cholecystectomy with intra operative cholangiography from August 2010 to July 2011 were studied. The outcome of cholangiogram was analyzed together with findings of Common bile duct exploration. Result and Conclusion: A total of 52 patients with acute mild biliary pancreatitis were operated during this period. The Common bile duct stone was found in 1.9%. Out of four patients with abnormal cholangiogram, only one patient (25%) had stone on exploration, rest of the three cases (75%) had negative exploration. The presence of common bile duct stone in case of mild acute biliary pancreatitis undergoing cholecystectomy is very low (1.96%), and thus policy of selective IOC should be applied for cases with mild biliary pancreatitis.

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Selective Management of Patients with Acute Biliary Pancreatitis

Cited by 19 publications

References 23 publications

Validation and improvement of a proposed scoring system to detect retained common bile duct stones in gallstone pancreatitis

Validation and improvement of a proposed scoring system to detect retained common bile duct stones in gallstone pancreatitis

Role of Computed Tomography In The Evaluation of Severity of Acute Pancreatitis

Presence of choledocholithiasis in patients undergoing cholecystectomy for mild biliary pancreatitis

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