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Surgical Endoscopy

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Open Access 01-05-2009 | Review

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

Authors: E. J. M. van Geenen, D. L. van der Peet, C. J. J. Mulder, M. A. Cuesta, M. J. Bruno

Published in: Surgical Endoscopy | Issue 5/2009

Abstract

Background

Recurrent attacks of acute biliary pancreatitis (RABP) are prevented by (laparoscopic) cholecystectomy. Since the introduction of endoscopic retrograde cholangiopancreaticography (ERCP), several series have described a similar reduction of RABP after endoscopic sphincterotomy (ES). This report discusses the different treatment options for preventing RABP including conservative treatment, cholecystectomy, ES, and combinations of these options as well as their respective timing.

Methods

A search in PubMed for observational studies and clinical (comparative) trials published in the English language was performed on the subject of recurrent acute biliary pancreatitis and other gallstone complications after an initial attack of acute pancreatitis.

Result

Cholecystectomy and ES both are superior to conservative treatment in reducing the incidence of RABP. Cholecystectomy provides additional protection for gallstone-related complications and mortality. Observational studies indicate that cholecystectomy combined with ES is the most effective treatment for reducing the incidence of RABP attacks.

Conclusion

From the literature data it can be concluded that ES is as effective in reducing RABP as cholecystectomy but inferior in reducing mortality and overall morbidity. The combination of ES and cholecystectomy seems superior to either of the treatment methods alone. A prospective randomized clinical trial comparing ES plus cholecystectomy with cholecystectomy alone is needed.

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Title: Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy
Authors: E. J. M. van Geenen
D. L. van der Peet
C. J. J. Mulder
M. A. Cuesta
M. J. Bruno
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 5/2009
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-009-0339-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Recurrent acute biliary pancreatitis: the protective role of cholecystectomy and endoscopic sphincterotomy

Abstract

Background

Methods

Result

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Result

Conclusion

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