| Conservative management of cholestasis with and without fever in acute biliary pancreatitis. | |
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MedLine Citation:
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PMID: 22530079 Owner: NLM Status: PubMed-not-MEDLINE |
Abstract/OtherAbstract:
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The presence of cholestasis in both mild and severe forms of acute biliary pancreatitis (ABP) does not justify, of itself, early endoscopic retrograde cholangiography (ERC) or endoscopic sphincterotomy (ES). Clinical support treatment of acute pancreatitis for one to two weeks is usually accompanied by regression of pancreatic edema, of cholestasis and by stone migration to the duodenum in 60%-88% of cases. On the other hand, in cases with both cholestasis and fever, a condition usually characterized as ABP associated with cholangitis, early ES is normally indicated. However, in daily clinical practice, it is practically impossible to guarantee the coexistence of cholangitis and mild or severe acute pancreatitis. Pain, fever and cholestasis, as well as mental confusion and hypotension, may be attributed to inflammatory and necrotic events related to ABP. Under these circumstances, evaluation of the bile duct by endo-ultrasonography (EUS) or magnetic resonance cholangiography (MRC) before performing ERC and ES seems reasonable. Thus, it is necessary to assess the effects of the association between early and opportune access to the treatment of local and systemic inflammatory/infectious effects of ABP with cholestasis and fever, and to characterize the possible scenarios and the subsequent approaches to the common bile duct, directed by less invasive examinations such as MRC or EUS. |
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Authors:
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José Sebastião Santos; Rafael Kemp; José Celso Ardengh; Jorge Elias Jr |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World journal of gastrointestinal surgery Volume: 4 ISSN: 1948-9366 ISO Abbreviation: World J Gastrointest Surg Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-04-24 Completed Date: 2012-10-02 Revised Date: 2013-05-29 |
Medline Journal Info:
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Nlm Unique ID: 101532473 Medline TA: World J Gastrointest Surg Country: China |
Other Details:
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Languages: eng Pagination: 55-61 Citation Subset: - |
Affiliation:
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José Sebastião Santos, Rafael Kemp, José Celso Ardengh, Division of Digestive Surgery, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, University of São Paulo, CEP 14049-900 São Paulo, Brazil. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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