Endoscopic Pancreatography in Management of Relapsing Acute Pancreatitis

Abstract

Endoscopic retrograde cholangiopancreatography (E.R.C.P.) was attempted in 31 patients suffering from repeated attacks of acute pancreatitis. Pancreatograms were obtained in 25 patients. Twelve showed definite “surgical lesions” (obstructions, strictures, or pseudocysts). In at least three patients failure to obtain a pancreatogram was due to obstruction of pancreatic duct close to the papilla. Two patients, both with pseudocysts, developed a mild relapse of pancreatitis after the procedure. Surgical intervention based on the x-ray findings seemed beneficial in the short follow-up period. Endoscopic pancreatography can be of value in deciding when surgery is advisable for patients with relapsing acute pancreatitis and in determining the operative appreach. It is an advance in the management of a difficult clinical condition.