ZenToks Publication

Chapter 15

An Update on the Management of Acute Gallstone Pancreatitis

Abstract/Preface

Acute gallstone pancreatitis represents the predominant etiology of acute pancreatitis and is categorized into mild and severe forms. The initial management of acute gallstone pancreatitis encompasses fluid resuscitation, supportive care, and analgesia, followed by definitive treatment. Endoscopic retrograde cholangiopancreatography (ERCP) is employed to extract the stone from the ampulla of Vater. In cases of acute gallstone pancreatitis with cholangitis, an urgent ERCP is indicated, whereas an early ERCP is performed for both mild and severe acute gallstone pancreatitis in the absence of cholangitis. Laparoscopic cholecystectomy is conducted to prevent recurrence, with early laparoscopic cholecystectomy being performed for mild cases and delayed laparoscopic cholecystectomy for severe cases. This chapter will explore the roles of endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy in the management of acute gallstone pancreatitis.