Prediction of common bile duct stones and cholangitis in acute biliary pancreatitis
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AbstractObjective: To define factors in predicting common bile duct (CBD) stones and cholangitis in patients with acute biliary pancreatitis. Method: Retrospective analysis of patients with acute biliary pancreatitis who received early (<72h) endoscopic retrograde cholangiopancreatography (ERCP). Data on their clinical presentation, severity of attacks, liver function on admission, ERCP findings and bile culture results were analysed. Results: Sixty-four patients admitted with acute biliary pancreatitis were referred for early ERCP. Common bile duct stones were found in 33 patients (52%). Only five (8%) patients presented with symptoms suggestive of coexisting acute cholangitis (fever, abdominal pain and jaundice). Bile cultures were positive in 12 of 18 specimens (67%), and nine of these (75%) were associated with choledocholithiasis. Variables were entered into a logistic regression analysis and a high bilirubin level on admission was the only significant factor in predicting ductal stones. Conclusion: In the locality of Hong Kong the incidence of choledocholithiasis is high in acute biliary pancreatitis and only a high bilirubin level can predict CBD stones. Although many patients have infected bile, overt cholangitis is relatively uncommon.
All Author(s) ListWong S.K.-H., Lam Y.-H., McKay C.J., Lee D.W.-H., Sung J.J.-Y., Chung S.S.-C.
Journal nameAnnals of the College of Surgeons of Hong Kong
Volume Number6
Issue Number1
PublisherBlackwell Publishing Inc.
Place of PublicationUnited Kingdom
Pages12 - 17
LanguagesEnglish-United Kingdom
KeywordsCholangitis, Choledocholithiasis, Endoscopic retrograde cholangiopancreatography, Pancreatitis

Last updated on 2020-02-12 at 01:03