Treatment of mild acute pancreatitis during pregnancy using retrograde cholangiography and endoscopic sphincterotomy

Abstract

normalization occurred within next 36 to 48 h. During endoscopy, the first case was identified as a gallstone-induced AP, the second one as idiopathic and suspected of occult microlithiasis, the third one was due to microvascular abnormalities-induced splanchnic ischemia, and the fourth one was a stenotic papillitis. No early recurrence of pancreatitis or fetal loss occurred. Results suggest that emergency papillotomy may have both diagnostic and therapeutic significance, with the minimal risk of post-sphincterotomy AP, and without an increase in the risk of fetal loss. Prevailing guidelines on AP management state that only patients with the severe type of disease should undergo urgent papillotomy [2,3] (the gold standard in the definitive treatment of the biliary AP), however consideration should be given to extending the therapeutic indications for emergency papillotomy to mild and idiopathic types of gestational AP. The risk of AP recurrence is 3-fold higher if previous AP was treated without papillotomy and next 10% of patients are suspected of having chronic pancreatitis in the future [4].