November 12, 2014
Reference Type: Journal Article
Record Number: 4944Author: Planells Roig, M., Ponce Villar, U., Peiro Monzo, F., Coret Franco, A., Orozco Gil, N., Banuls Matoses, A., Sanchez Aparisi, E., Marti Gonzalez, L. and Caro Martinez, F.
Title: Biliary pancreatitis. Liver function tests and common biliopancreatic channel kinetics – biliopancreatic reflux
Journal: Cir Esp
Date: Sep 14
Short Title: Biliary pancreatitis. Liver function tests and common biliopancreatic channel kinetics – biliopancreatic reflux
Alternate Journal: Cirugia espanola
ISSN: 1578-147X (Electronic)
Original Publication: Pancreatitis biliar. Cinetica de pruebas funcionales hepaticas y canal comun biliopancreatico – reflujo biliopancreatico.
Accession Number: 24041581
Abstract: OBJECTIVE: To determine the prevalence of biliopancreatic reflux (BPR) in patients with biliary pancreatitis (BP) undergoing elective cholecystectomy with intraoperative cholangiography (IOC) in comparison with a control group of symptomatic cholelithiasis (CG). PATIENTS AND METHODS: Retrospective review of 107 consecutive BP cases. BPR was determined by IOC and liver function tests (LFT) were recorded at admission (A), 48hours, and preoperative examination (P). LFT analysis between A and P were analysed between groups with respect to BPR, time interval to cholecystectomy within the same group and by determination of observed value/maximum normal value ratio (OV/MNV). RESULTS: BPR incidence was 38.3% in BP in comparison with 5% in CG (p=0.0001) it was independent from interval time to cholecystectomy, in contrast with Odditis, suggesting an anatomical condition for CCBP and a functional one for Odditis. LFT analysis showed no differences in relation to BPR incidence. LFT excluding AP and GGT returned to normal values with significant differences in OV/MNV when BPR was present which points to an increased cholestasis in BPR group. US dilatation of CBD was noted in 10.3% and was associated to CCBP. CONCLUSIONS: BPR in BP increases cholestasis and contributes to confusion in the estimation of common bile duct stones increasing ERCP-EE rates. US and biochemical markers of CBDS show a low specificity due to BPR-CCBP which suggests that MRI-cholangiography is a mandatory exploration before ERCP-EE examination.