Assessment of main pancreatic duct integrity by endoscopic retrograde pancreatography in patients with acute pancreatitis

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Abstract
The integrity of the main pancreatic duct (MPD) was evaluated by endoscopic retrograde pancreatography (ERP) in a retrospective study of 105 patients with acute pancreatitis presenting over an 11-year period (1980–1991). The findings were compared with clinical outcome and the need to operate for local pancreatic complications. Patients were divided into two groups. Group 1 (n = 89) had either clinically mild pancreatitis or severe disease but no surgery for local complications, and <25 per cent necrosis on contrast-enhanced computed tomography (CT) (n = 48). Group 2 patients (n = 16) had clinically severe pancreatitis and underwent surgery for local complications and/or had ≧ 25 per cent necrosis on CT (n = 12), at surgery or post mortem. All 89 patients in group 1 had an intact MPD at ERP, which was performed a median of 6 (range 0–30) days after onset of pancreatitis; the median age was 63 (range 20–88) years and there were no deaths. The median age of patients in group 2 was 59 (range 26–85) years. ERP in this group was performed in four patients 4 days after onset in patients with necrosis necessitating surgery.