Indications and Contraindications for ERCP in Patients with Acute Biliary Pancreatitis

Recent guidelines published by the American College of Gastroenterology suggest that urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 hours after admission) is indicated in patients with biliary pancreatitis who have concurrent acute cholangitis, but it is not needed in most patients who do not have evidence of ongoing biliary obstruction.
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ROME II Diagnostic Criteria for Functional Disorders of the Biliary Tract and the Pancreas

The diagnosis of a Functional Disorder of the Biliary Tract and Pancreas always pre-sumes the absence of a structural or biochemical explanation for the symptoms.

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ROME II Diagnostic Criteria for Functional Disorders of the Biliary Tract and the Pancreas

The diagnosis of a Functional Disorder of the Biliary Tract and Pancreas always pre-sumes the absence of a structural or biochemical explanation for the symptoms.
E1. Gallbladder Dysfunction
Episodes of severe steady pain located in the epigastrium and right upper quadrant, and all of the following:

  1. Symptom episodes last 30 minutes or more, with pain-free intervals;
  2. Symptoms have occurred on one or more occasions in the previous 12 months;
  3. The pain is steady and interrupts daily activities or requires consultation with a physician;
  4. There is no evidence of structural abnormalities to explain the symptoms; and
  5. There is abnormal gallbladder functioning with regard to emptying. Continue reading