Table 3.
Summary table of the role of ERCP in pancreatitis.
Diagnosis | Management | |
---|---|---|
1. | Acute biliary pancreatitis | Early ERCP should be considered only in selected patients with co-existing cholangitis or biliary obstruction |
2. | Sphincter of Oddi dysfunction (SOD) Type I SOD (papillary stenosis) Type II SOD (functional) Type III SOD |
Endoscopic sphincterotomy Endoscopic sphincterotomy in selected cases with positive SOM Endoscopic sphincterotomy is not indicated |
3. | Pancreas divisum | Endotherapy (minor papillotomy ± stenting) should be performed only in cases with well-documented episodes of pancreatitis |
4. | Chronic pancreatitis a.Pancreatic ductal calculi b.Pancreatic ductal stricture |
Endotherapy is indicated in those with a single dominant stricture or solitary calculus in the head ESWL ± ERCP recommended for large (>5 mm) PD calculi Endotherapy with 1 or more plastic stents for 1 year Multiple plastic stents in symptomatic refractory strictures |