Acute biliary pancreatitis (ABP) with and without obstructive signs on ERCP – When is endoscopic sphincterotomy (EST) needed?

It is generally accepted that patients (pts) with ABP and common bile duct (CBD) stones may benefit from early ERCP and EST. The aim of this study was a prospective analysis of the clinical outcome of ABP pts with and without obstructive signs (CBD stone or dilatation) on the cholangiographic picture after early ERCP and EST. 39 consecutive pts with suspected ABP were referred for early ERCP. Non-alcoholic pts with acute pancreatitis associated with biliary abnormalities on US and concomitant early elevation of obstructive LFTs were selected. In all pts, ERCP was performed within 2 days of the initial disease pr…