The most common cause of acute pancreatits are alcohol intake and the gallbladder stone. When acute pancreatitis is caused by biliary stones it is called as biliary pancreatitis. Biliary pancreatitis management involve team work of critical care doctor, Gastrophysician, GI surgeon & intervention Radiologist
Clinical Features of Pancreatitis
Patients present with features of acute pancreatitis like severe acute abdomen pain radiating to back; Investigations show increased serum amylase and Lipase level with deranged Liver function tests (LFT)
Biliary pancreatitis management
Biliary pancreatitis management is supportive. To know the status of Common bile duct MRI/MRCP abdomen is done. Mostly stone has passed through the Common bile duct into the duodenum. If the MRI/MRCP show stone in the common bile duct then patient require ERCP and CBD stone clearance. If the patient condition is not stable and is in cholangitis/septic shock ERCP is done on urgent basis otherwise ERCP is done on elective basis once pancreatitis settle.
The Gallbladder is removed during same hospitalization in mild biliary pancreatitis management with no associated fluid collection as gallstone is the cause and is the source and if not removed patient may again develop pancreatitis. Cholecystectomy is advised after 4 weeks in moderate and in severe biliary pancreatitis management as if some comlications of pancreatitis requiring intervention, that can also be done at same time. Indications for surgery for pancreatitis remains the same such as infected pancreatic necrosis. Pancreatic necrosectomy should be delayed and ideally should be done after 4 weeks of episode.
Know more on Pancreatitis
Pancreatitis disease is common with very high morbidity and mortality rate. Alcohol is the most common culprit and should be avoided. Dr Amit Jain with his advance laparoscopic approach is specialize to do pancreatic necrosectomy with minimally invasive approach which has got low morbidity and mortality.