On the prevention of the recurrence of acute biliary pancreatitis / 中国微创外科杂志

ABSTRACT

Objective To explore clinical methods for preventing the recurrence of biliary pancreatitis.Methods Clinical data of 112 consecutive cases of acute biliary pancreatitis from January 1999 to July 2001 treated in this hospital were analyzed retrospectively.Before admission all the patients had no history of biliary pancreatitis or cholecystectomy.According to whether or not an endoscopic sphincterotomy(EST) or cholecystectomy was given,the patients were divided into 4 groups Conservative Group(n=45),EST Group(n=22),Cholecystectomy Group(n=29),and Combination Group(n=16).The recurrence rates of pancreatitis of the 4 groups were compared each other.Results The 112 patients were followed for 16~30 months(mean,18.5 months).Recurrence of pancreatitis was found in 12 patients in the Conservative Group(26.7%,12/45) and in 2 patients in the Cholecystectomy Group(6.9%,2/29).No recurrence was seen in the EST Group and the Combination Group.As compared with the Conservative Group,both EST and cholecystectomy significantly decreased the recurrence rate of biliary pancreatitis.The 2 recurrent patients in the Cholecystectomy Group were given an endoscopic retrograde cholangiopancreatography(ERCP),by which small common bile duct calculi were found.Conclusions Common bile duct calculus is the major cause of recurrence of biliary pancreatitis.Both EST and cholecystectomy can decrease the recurrence rate of biliary pancreatitis.EST is suitable for elderly high-risk patients because of its minimal invasion.