Managing Biliary Pancreatitis

Acute pancreatitis is the most common gastrointestinal cause for acute hospital admissions in the United States. Its global incidence has been rising steadily through the years. In Europe, its incidence has been increasing at a median rate of 3.4% per year. Although acute pancreatitis has multiple etiologies, biliary stone disease is the most frequent cause in Europe accounting for 45% of cases, followed by alcohol abuse (20%). Most patients with acute pancreatitis, including those with a biliary cause, recover quickly without major clinical sequelae. About 20% of cases, however, run a severe disease course with local (necrosis) and systemic (systemic inflammatory response syndrome, infected necrosis, multi-organ failure) complications with the need for care from a multidisciplinary team in an intensive care unit. In these patients, despite aggressive management, mortality ranges between 20 and 40%. In view of the rising incidence of acute biliary pancreatitis and its associated morbidity and mortality, utilization of health care resources and costs are substantial.