Endoscopic sphincterotomy in acute gallstone pancreatitis and cholangitis: a Saudi hospital experience.

Thirty-five patients with acute gallstone pancreatitis and/or cholangitis underwent endoscopic sphincterotomy. In 15 out of 18 patients with acute gallstone pancreatitis, common bile duct (CBD) stones, 5 of which were impacted, were removed. This resulted in prompt improvement in 12 of these patients. Eleven patients had acute gallstone cholangitis in ten of whom--including one patient who had cholangiocarcinoma associated with Clonorchis sinensis--CBD stones were extracted. Six other patients had both acute pancreatitis and cholangitis, one of whom had a choledochal cyst and had surgery; another patient with a post-surgical CBD fistula and retained stone, improved following stone extraction and nasobiliary tube insertion. The duration of hospitalization ranged between 5 and 19 days in the 26 patients treated endoscopically, and between 25 and 90 days in the 9 surgically treated patients.