Abstract
IP accounts for 10-30% of acute pancreatitis. Purpose: To assess the role of ERCP, biliary crystal analysis, sphincter of Oddi manometry (SOM), endoscopic sphincterotomy (ES) and minor papilla (MP) therapeutics in IP. Methods: 126 patients with IP (mean age: 44 yrs.) were identified. Mean episodes of pancreatitis were 3.2(range 2-7). Papillary stenosis was defined as dilated duct (CBD >10mm and/or PD >5mm) with delayed drainage (CBD >45 min. and/or PD >10 min.). Patients with normal ERCP underwent SOM with IV CCK provocation and with gallbladder (GB) in situ also had bile collection after CCK stimulation for crystal (cholesterol and/or calcium bilirubinate) analysis. Results: (see table below). Conclusions: ERCP techniques: MP cannulation, bile crystal analysis and SOM in selected patients identified an etiology in 79% (endoscopically treatable in 75%) of patients with IP, with or without cholecystectomy.
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