How can gallstone pancreatitis be treated?
The use of ERCP in patients with gallstone pancreatitis is controversial. The literature indicates that in patients without biliary obstruction, ERCP does not benefit them and may even produce complications that make the disease worse. Overall, Baillie says, experts recommend urgent ERCP for biliary compression only for patients with progressive biliary obstruction (who have progressive jaundice with or without cholangitis). It is not necessary to perform preoperative ERCP in all patients undergoing laparoscopic cholecystectomy; the surgeon should, alternatively, perform intraoperative cholangiography, with ERCP incorporated if bile duct stones are found. However, patients with a suspected or known surgical reconstruction of the gut should undergo preoperative ERCP, which may help the surgeon plan her approach. Preoperative ERCP should also be performed in patients with persistent or progressive biliary obstruction (regardless of choledocholithiasis); surgery should then follow the bil
