Biliary drainage in the diagnosis of acute idiopathic pancreatitis

: The identification of a casual agent in the so-called "idiopatic acute pancreatitis" is of great interest in relationship with the prognosis and the election of correct therapy. We have performed a duodenal drainage for the microscopic study of the bile, looking for cholesterol crystals and bilirrubinate's in a group of 19 patients with idiopatic acute pancreatitis. The results have been compared with a control group composed by 45 assymptomatic individuals. In the patients group drainage results were abnormal in 11 cases (57.9%) vs. 11.2% in the control group (difference statistically significant). In 4 of the 11 cases, a cholecystectomy was performed showing biliary pathology. Patients at follow-up were assymptomatic. Duodenal drainage is an easy method without risks that must be used always in idiopatic acute pancreatitis. It allows the diagnosis of microlithiasis and may help in the therapeutic indication of cholecystectomy.