Abstract
Urgent endoscopic sphinterotomy (ES) has been proposed during severe acute biliary pancreatitis (ABP) in order to reduce morbility and mortality. However, is used in mild and moderate ABP as a diagnostic and therapeutic tool when choledocolithiasis is strongly suspected, though lithiasis migration is a well known entity. Endoscopic ultrasound (EUS) is a less invasive method and could identify a subgroup of patients where choledocolithiasis is really diagnosed and treated by ES.AIM OF THE STUDY: To determine EUS place in the ABP algorithm. PATIENTS AND METHODS: Between July 98 and October 99, 13 patients with ABP, mean age 40 years (range 18-60 years) were studied prospectively in our center. All of them had gallbladder lithiasis suggested by abdominal ultrasound and extrahepatic cholestasis (elevated alcaline fosfatase >than 2N and elevated aminotrasaminases >than 2N) with acute pancreatitis. EUS was performed before hospitalization (
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