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2003, Number 2

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Cir Gen 2003; 25 (2)

The role of endoscopy in acute pancreatitis

Mora LJG

Language: Spanish
References: 33
Page: 137-142
PDF size: 59.63 Kb.


ABSTRACT

Objective: To analyze the medical bibliography on the usefulness of endoscopy for acute pancreatitis.
Data collection: Bibliographic review covering the years from 1998 to 2002 (33 references were chosen).
Selection of studies: The most relevant articles on the subject were chosen.
Data extraction: The international medical literature covering the years from 1998 to 2002 was reviewed on the usefulness of endoscopy for acute pancreatitis. The MEDLINE database was used for the search.
Results: Endoscopic cholangiopancreatography (ECP) with sphincterotomy reduces morbidity and mortality in patients with severe biliary pancreatitis. Those patients with cholangitis or biliary tract obstruction are the most benefited. Its usefulness in mild biliary pancreatitis is controversial. However, it could be indicated in deteriorating patients or in those showing no improvement after 2-3 days, in those in whom cholecystectomy cannot be performed, or in those in whom surgery will not be performed soon, as well as in those patients in whom the severe symptoms have been resolved. Endoscopic ultrasound (EUS) is equally sensitive as ECP for the diagnosis of choledocholithiasis but less specific. Besides, the presence of peripancreatic liquid and the absence of a thick echotexture parenchyma predict a longer duration of symptoms. The use of microscopic analyses of the bile, of ECP with manometry of the Oddi sphincter, or of EUS might reduce the percentage of “idiopathic cases” below 7%.
Conclusion: Endoscopy is a useful tool for the management of patients with acute pancreatitis, therefore the surgeon must know its indications and limitations.


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