Background/Aims: If gallstone pancreatitis is not properly treated, the morbidity, mortality rate and recurrence are high. We reviewed 36 cases of gallstone pancreatitis which were treated at the Department of General Surgery, Pusan
National University Hospital, from Jan. 1986 to Dec. 1995 and reached the following conclusions.
Results: The most frequent clinical presentation was epigastric pain in 31 cases(86.1%) while other clinical presentations were fever and chilling in 25 cases(69.4%), and jaundice in 23 cases(63.9%). The serum amylase level, GOT, GPT, total bilirubin and alkaline photophatase were higher than normal. Ultrasonography, which is used in the early detection of gallstone, was performed in 34 cases(94.4%), and ERCP was performed in all 16 cases(44.4%) which were conventionally managed. The reflux of dye to the pancreatic duct was observed in 28 cases(77.8%), while through intraoperative cholangiography or T-tube cholangiography, reflux was observed in 21 cases(75%). The operative procedure was performed according to prognostic factors at admission and 48 hours after admission. The cholecystectomy and common bile duct exploration was most commonly performed after 48 hours. The operative procedure which was performed after conservative theraphy was cholecystedtomy, and the common bile duct stone was removed through endoscopic sphincterotomy after ERCP. Complications developed in 3 (21.4%) of 14 cases which were suspected poor prognosis at admission, and 2 (33.3%) of 6 cases which were suspected poor prognosis after 48 hours.
Conclusion: We suggest that reflux to the pancreatic duct is an important factor in gallstone pancreatitis. Operative procedure was delayed after symptom relief.
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