Treatment of Acute Biliary Pancreatitis

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Abstract
Almost 100 years ago, Opie postulated that a gallstone transiently obstructing the ampulla of Vater — the channel where the bile duct and pancreatic duct meet — could precipitate pancreatitis.1 At least half of all cases of pancreatitis are due to the passage of gallstones; we know this because stones are found in the bile ducts and stools of the affected patients.2 When alcohol consumption, trauma, certain metabolic abnormalities, tumors, and a host of rare causes, from ischemia to ascariasis, are ruled out, gallstones are the number-one suspect worldwide.3 There is little doubt about the diagnosis of biliary pancreatitis when . . .