Endoscopic management of acute recurrent pancreatitis

Abstract

The aetiology of acute pancreatitis is usually identified and treated in over 80% of the patients. However, when pancreatitis recurs, a further diagnostic work up is needed in order to discover the causative factors. A few years ago ERCP was a primary diagnostic and therapeutic tool in this field but the contribution of EUS and MRCP has changed the diagnostic algorithm of acute recurrent pancreatitis. Established (microlithiasis, neoplasms) and controversial (pancreas divisum, sphincter of Oddi dysfunction) aetiologies of acute recurrent pancreatitis may now be identified with noninvasive procedures, limiting the role of ERCP to its therapeutic arm. In this review the endoscopic management of acute pancreatitis is discussed.