Urgent ERCP reduce complications in acute biliary pancreatitis

Background: Acute biliary pancreatitis (ABP) is a serious complication of biliary stones disease and is associated with relative high mortality. Early endoscopic retrograde cholangio-pancreatography (ERCP) with endoscopic sphincterotomy (EST) has been advocated to reduce complications in patients presenting with ABP. In this study we're going to demonstrate the importance of urgent ERCP in patients with acute biliary pancreatitis.

Methods: 78 patients (♂37/♀41) from Jan. 2006. to Dec 2008. were revised. We collected data of age, hospital stay, duration between admission and urgent ERCP, the complications, the necessity of intensive care and surgery intervention. Both severe (Ranson score ≥3) and mild (Ranson score=1–2) ABP were included. Patients were divided into three groups by the duration between admission and successful urgent ERCP. (1. group: t <12h, 2. gr.: t=12–24h, 3. gr.: t >24h) and compare them to mean hospital stay, the percent of patients who had complications, necessity of intensive care and surgery intervention.

Results: First group: 31 patients (15/16), on average 55,35 years old, mean hospital stay 10,84 days, in 32,26% of the cases occured complications, 6 patients (19,35%) required intensive care and 1 patient (3,22%) surgery intervention. Second group: 28 patients (12/16), on average 57,07 years old, mean hospital stay 16,75 days, in 42,86% of the cases occurred complications, 8 patients (27,57%) required intensive care and 6 patients (21,05%) surgery intervention. Third group: 19 patients (10/9), on average 63,89 years old, mean hospital stay 10,42 days, in 52,63% of the cases occurred complications, 4 patients (21,05%) required intensive care and 1 patient (5,26%) surgery intervention.

Conclusion: Urgent ERCP significantly reduce complications in acute biliary pancreatitis, and also narrow the hospital stay. The necessity of intensive care and surgery intervention could be decreased too.