肝臓学および胃腸疾患ジャーナル
オープンアクセス

概要

Acute Biliary Pancreatitis Diagnosis and Endoscopic Treatment Experience of our Department

Firwana M, Aomari A, Sidki I, Benelbarhdadi I, Ajana FZ, Afifi R and Essaid AE

Introduction: Bile stone is the main cause of acute pancreatitis (AP) and one of the few etiologies that can benefit from specific and curative treatment. The purpose of our work is to evaluate our experience of endoscopic treatment of acute biliary pancreatitis. Materials and method: Retrospective study performed in the hepatogastroenterology "C" department of Ibn Sina hospital in Rabat, we included patients who had acute biliary pancreatitis and endoscopically treated. Results: We included 42 patients, the women/man sex ratio=3.2, the mean age was 51.5 years. A history of acute pancreatitis (AP) was reported in 8 cases and cholecystectomy in 15 cases. Arguments for retaining biliary origin were cytolysis greater than 3 times normal in 18 cases, presence of retentional jaundice in 4 cases, cholangitis in 3 patients, primary biliary stone on ultrasound in 8 cases and choledochal dilatation without obstacle image in 15 cases. Bili-MRI was performed in 6 patients with confirmation of biliary origin in 2 patients. The degree of severity of AP was Balthazar stage A in 14 cases, stage B in 7 cases, stage C in 4 cases and E in 6 cases. In 7 cases severity was not specified. Endoscopic retrograde cholangiopancreatography (ERCP) showed a stone image in 17 cases, dilatation of the bile duct in 31 cases. Stone extraction was successful in 38 patients. Sphincterotomy was performed in 34 cases, of which 4 cases benefited from placement of pancreatic or biliary prosthesis. Immediate complications are marked by a minor bleeding stopped spontaneously. In patients with gallbladders in place, a cholecystectomy was scheduled in the subsequent ERCP. Conclusion: The endoscopic treatment of acute biliary pancreatitis in our experience, proved its efficacy without added morbidity.