Chapter 54: Pancreas- Gallstone Pancreatitis Flashcards
What is it?
Acute pancreatitis from a gallstone in or passing through the ampulla of Vater (the exact mechanism is unknown)
How is the diagnosis made?
Acute pancreatitis and cholelithiasis and/or choledocholithiasis and no other cause of pancreatitis (e.g., no history of alcohol abuse)
What radiologic tests should be performed?
- U/S to look for gallstones
- CT scan to look at the pancreas, if symptoms are severe
What is the treatment?
Conservative measures and early interval cholecystectomy (laparoscopic cholecystectomy or open cholecystectomy) and intraoperative cholangiogram (IOC) in 3 to 5 days (after pancreatic inflammation resolves)
Why should early interval cholecystectomy be performed on
patients with gallstone pancreatitis?
Pancreatitis will recur in ≈33% of patients within 8 weeks (so always perform early interval cholecystectomy and IOC in 3 to 5 days when pancreatitis resolves)
What is the role of ERCP?
- Cholangitis
- Refractory choledocholithiasis