Chapter 54: Pancreas- Gallstone Pancreatitis Flashcards

1
Q

What is it?

A

Acute pancreatitis from a gallstone in or passing through the ampulla of Vater (the exact mechanism is unknown)

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2
Q

How is the diagnosis made?

A

Acute pancreatitis and cholelithiasis and/or choledocholithiasis and no other cause of pancreatitis (e.g., no history of alcohol abuse)

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3
Q

What radiologic tests should be performed?

A
  • U/S to look for gallstones
  • CT scan to look at the pancreas, if symptoms are severe
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4
Q

What is the treatment?

A

Conservative measures and early interval cholecystectomy (laparoscopic cholecystectomy or open cholecystectomy) and intraoperative cholangiogram (IOC) in 3 to 5 days (after pancreatic inflammation resolves)

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5
Q

Why should early interval cholecystectomy be performed on
patients with gallstone pancreatitis?

A

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)

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6
Q

What is the role of ERCP?

A
  • Cholangitis
  • Refractory choledocholithiasis
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