Dupont B, Lozac'h J, Alves A. Etiological treatment of gallstone acute pancreatitis. World J Gastrointest Surg 2025; 17(5): 105410 [DOI: 10.4240/wjgs.v17.i5.105410]
Corresponding Author of This Article
Benoît Dupont, MD, Department of Hepato-Gastroenterology and Nutrition, Caen Normandy University Hospital, Normandy University, Côte de Nacre Avenue, Caen 14000, Normandie, France. dupont-be@chu-caen.fr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2025; 17(5): 105410 Published online May 27, 2025. doi: 10.4240/wjgs.v17.i5.105410
Etiological treatment of gallstone acute pancreatitis
Benoît Dupont, Justine Lozac'h, Arnaud Alves
Benoît Dupont, Justine Lozac'h, Department of Hepato-Gastroenterology and Nutrition, Caen Normandy University Hospital, Normandy University, Caen 14000, Normandie, France
Arnaud Alves, Department of Digestive Surgery, Caen Normandy University Hospital, Normandy University, Unicaen, Caen 14000, Normandie, France
Author contributions: Dupont B contributed to the conceptualization, writing-original draft preparation, and visualization of this manuscript; Dupont B and Lozac’h J participated in the writing-review & editing; Alves A contributed to the supervision; all authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Benoît Dupont, MD, Department of Hepato-Gastroenterology and Nutrition, Caen Normandy University Hospital, Normandy University, Côte de Nacre Avenue, Caen 14000, Normandie, France. dupont-be@chu-caen.fr
Received: January 21, 2025 Revised: February 25, 2025 Accepted: March 7, 2025 Published online: May 27, 2025 Processing time: 122 Days and 9.1 Hours
Abstract
Gallstone pancreatitis is the leading cause of acute pancreatitis, accounting for more than 40% of cases. Etiological treatment is a critical issue in acute biliary pancreatitis as it helps reduce the risk of recurrence. Patients who have experienced a complicated form of biliary disease are at high risk for recurrent episodes, and the severity of these new episodes can be unpredictable. In recent years, the role and timing of cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP), which are the main therapeutic interventions in the etiological treatment, have been considerably clarified. This review aims to detail the different aspects of the etiological treatment of acute biliary pancreatitis. Currently, it is established that cholecystectomy should be performed early during the initial hospitalization in cases of non-severe acute pancreatitis. However, the optimal timing of this procedure in severe acute pancreatitis remains a subject of debate. Emergency ERCP is no longer indicated for acute biliary pancreatitis, except in cases of associated acute cholangitis. ERCP can be useful for the management of persistent bile duct stones. Finally, the role of interval sphincterotomy in frail or elderly patients or to reduce the risk of recurrence in those awaiting cholecystectomy in cases of severe acute pancreatitis remains to be fully established.
Core Tip: Gallstone pancreatitis is the leading cause of acute pancreatitis, accounting for more than 40% of cases. Etiological treatment is a critical issue in acute biliary pancreatitis as it helps reduce the risk of recurrence. This review aims to determine the role and timing of cholecystectomy and endoscopic retrograde cholangiopancreatography in the management of acute biliary pancreatitis in the general population. Special attention will also be given to the care of frail and elderly patients, a group frequently affected by this condition.
