Consideration of endoscopic retrograde cholangiopancreatography in cases of acute biliary pancreatitis.

AIM: The important question to be answered in all cases of ABP is whether or not a calculous biliary obstruction is still present. Answering this question conditions subsequent management, including the need for endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to determine the relationship between persistent common bile duct stone (CBDS) and laboratory values, and dilation of bile duct in order to find possible significant associations in patients with acute biliary pancreatitis (ABP). METHODS: Retrospectively, statistical evaluation of a group of 76 patients with ABP who had received early ERCP. RESULTS: The prevalence of choledocholithiasis in patients > 70 years old was 54.2%, in patients 70 years old with bile duct dilation was 81.3%; in the absence of bile duct dilation CBDS was not present, p 70 years old, p = 0.02. CONCLUSIONS: ERCP is indicated in patients with ABP if biliary obstruction is present and the presence of a ductal stone is suspected. From our results it is clear that the predictive parameter for choledocholithiasis is the dilation of the bile duct and previous cholecystectomy. In patients with bile duct dilation possible predictive factors are Bi, ALT, and GMT (Tab. 1, Fig. 8, Ref. 20).