Endoscopic Sphincterotomy in Acute Pancreatitis

Abstract

Cholelithiasis is a common finding in acute pancreatitis: 41% according to Mercadier and Baubion (3), 62.5% according to Kelly (2), and 88.6% according to Mouiel et al. (4). Rational endoscopic sphincterotomy is based upon two main factors contributing to treatment and prevention of repetitive attacks of biliary pancreatitis — the complete extraction of stones in the common bile duct and the maintenance of a biliary drainage in the duodenum through a distinct opening, separated from the pancreatic duct. Endoscopic cholangiopancreaticography (ERCP) is well adapted to detection of biliary origin of acute pancreatitis (Dunham et al. (1)), and endoscopic sphincterotomy is proposed when stones are demonstrated in the common bile duct in the course of this exploration.