Gallstone Pancreatitis
Autor: | Christian de Virgilio, Stanley R. Klein, L Chang, Christopher Verbin, Bruce E. Stabile, Stuart Linder |
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Rok vydání: | 1994 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Gallstones digestive system Gastroenterology Preoperative care Internal medicine Preoperative Care medicine Humans Aged Retrospective Studies Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test Common bile duct business.industry Gallbladder Middle Aged medicine.disease Endoscopy Surgery medicine.anatomical_structure Cholecystectomy Laparoscopic Pancreatitis Hyperamylasemia Female Cholecystectomy business |
Zdroj: | Archives of Surgery. 129:909 |
ISSN: | 0004-0010 |
DOI: | 10.1001/archsurg.1994.01420330023005 |
Popis: | Objectives: To evaluate the efficacy of endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy in patients with gallstone pancreatitis and to determine criteria predictive of common bile duct stones (CBDS). Design: Retrospective chart review. Patients: Seventy-one consecutive patients with gallstone pancreatitis. Main Outcome Measures: Identification and endoscopic management of CBDS, complications, and mortality. Results: Preoperatively, ERCP revealed CBDS in seven of 22 patients and postoperatively, in five of six patients All stones were successfully removed. Laboratory values and common bile duct dilatation on admission did not predict CBDS. Persistent hyperamylasemia (>150 U/L) and persistent hyperbilirubinemia (>29.07 μmol/L [1.7 mg/dL]) were associated with CBDS on ERCP or intraoperative cholangiography. All five patients with cholangitis underwent ERCP, and CBDS were found and removed in four. There were no deaths and there was a 7% complication rate. Conclusions: Gallstone pancreatitis can be effectively managed by selective ERCP, endoscopic sphincterotomy, and laparoscopic cholecystectomy. Preoperative ERCP can be restricted to patients with cholangitis, persistent hyperbilirubinemia, or persistent hyperamylasemia. (Arch Surg. 1994;129:909-913) |
Databáze: | OpenAIRE |
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