Choledocholithiasis in acute gallstone pancreatitis. Incidence and clinical significance
A. Oria, J. Alvarez, L. Chiappetta, J. C. Spina, N. Hernandez, M. Iovaldi, C. Ocampo and A. Paladino
Department of Surgery, Cosme Argerich Hospital, Buenos Aires, Argentina.
A prospective study of choledocholithiasis was performed using 110 patients
with presumptive diagnoses of acute gallstone pancreatitis. The incidence
of migrating and persistent bile duct stones was determined using stool
screening and intraoperative cholangiography, and the clinical significance
of continued stone obstruction of the papilla was investigated using
ultrasound assessment of migration time and a second evaluation of
prognostic signs. Pancreatic inflammation was confirmed at surgery in 51
patients, of whom only 27 had stones in the stools (n = 22) or the bile
duct (n = 5), suggesting that choledocholithiasis may not be the sole
triggering factor of acute gallstone pancreatitis. Neither delayed
migration nor persistent stone obstruction of the papilla promoted
pancreatic inflammation.
