The Early Treatment of Acute Biliary Pancreatitis

To the Editor: A problem with the study by Fan et al. (Jan. 28 issue) 1 is the authors' inability to distinguish reliably patients presenting with acute pancreatitis and secondary biliary obstruction from those presenting with primary biliary obstruction and sepsis. At least one of the patients...

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Bibliographic Details
Published inThe New England journal of medicine Vol. 329; no. 1; pp. 58 - 59
Main Author Clavien, P A
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 01.07.1993
Subjects
Acute Disease
Cholangiopancreatography, Endoscopic Retrograde
Emergencies
Gallstones - diagnosis
Gallstones - therapy
Humans
Pancreatitis - diagnosis
Pancreatitis - therapy
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Summary:To the Editor: A problem with the study by Fan et al. (Jan. 28 issue) 1 is the authors' inability to distinguish reliably patients presenting with acute pancreatitis and secondary biliary obstruction from those presenting with primary biliary obstruction and sepsis. At least one of the patients randomly assigned to initial conservative treatment had a serum bilirubin concentration of 37.2 mg per deciliter. Patients who present with acute abdominal symptoms, fever, and leukocytosis should probably undergo emergency endoscopic retrograde cholangiopancreatography (ERCP), regardless of their serum amylase concentrations 2 . Furthermore, even in patients with unequivocal pancreatitis, potentially life-threatening biliary obstruction cannot always . . .
Bibliography:SourceType-Other Sources-1
content type line 63
ObjectType-Correspondence-1
ObjectType-Commentary-2
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJM199307013290114