Etiologic diagnosis is important in the management of a patient with acute pancreatitis. Early differentiation of gallstone pancreatitis from nongallstone pancreatitis by imaging methods is often difficult. The objectives of this study are to
assess
values of clinical and laboratory data in establishing gallstone as an etiology of pancreatitis and to analyze endoscopic retrograde cholangiopancreatogrophy (ERCP) findings of gallstone pancreatitis.
Age, sex, serum alkaline phosphatase, aminotransferase (SGPT), amylase, lipase, and total bilirubin levels were significantly different (p<0.05, chi square) between gallstone and nongallstone groups.
The items which favor gallstone pancreatitis are age≥50 years, female sex, amylase≥1000 IU/ml, lipase≥3000 IU/ml, SGPT≥100 IU/L, alkaline phosphatase≥400 IU/L, and total bilirubin≥2.5mg dl. It was found that, those who had more than 4 of
above
factors (21 cases) were were more likely to have gallstone pancreatitis (15 cases, 71.4%). ERCP findings of 22 patients with gallstone pancreatitis were analysed. 15 cases (68.2%) had common bile duct stones, of which 9 had undertaken endoscopic
sphincterotomy and removal of stones.
in conclusion, clinical and biochemical predictive systems for presence of gallstones in acute pancreatitis may have useful roles in ve(?) uation of etiology in acute pancreatitis and in planning early interventional treatment. ERCP and
endoscopic
sphincterotomy in gallstone pancreatitis are safe and effective diagnostic and therapeutic measures.
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