What and When for ERCP with Gallstone Pancreatitis

A recent case vignette highlights several key points regarding use and timing of ERCP (endoscopic retrograde cholangiopancreatography) for gallstone pancreatitis (NEJM 2014; 370: 150-7). Figure 1 provides a nice illustration of ERCP.

Indications:  Suspected bile-duct stones as the cause of pancreatitis AND one of the following:

  • cholangitis (fever, jaundice, sepsis)
  • persistent biliary obstruction (conjugated bilirubine level >5 mg/dL)
  • clinical deterioration (worsening pain, increasing white cell count, worsening vital signs)
  • stone evident in the common bile duct on imaging

AGA position paper (2007):

  • Urgent ERCP (within 24 hours of admission) was recommended in those with cholangitis
  • Early ERCP (within 72 hours of admission) was recommended if suspicion of persistent bile-duct stones remained high

Patient information/animated videos for pancreatic diseases from the National Pancreas Foundation: http://ow.ly/sF9vb 

Related post:

Indomethacin to prevent post-ERCP pancreatitis | gutsandgrowth

5 thoughts on “What and When for ERCP with Gallstone Pancreatitis

  1. Pingback: Why an ERCP Study Matters to Pediatric Care | gutsandgrowth

  2. Pingback: NASPGHAN Postgraduate Course 2014 -Endoscopy Module | gutsandgrowth

  3. Pingback: In the News …CRE due to ERCPs | gutsandgrowth

  4. Pingback: When A Disease Turns Out to Be Fictitious -The Sad Story on Sphincter of Oddi Dysfxn | gutsandgrowth

  5. Pingback: What to Do with Adolescents with Common Bile Duct Stones | gutsandgrowth

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.