Role and timing of endoscopy in acute biliary pancreatitis

Core Tip

Core tip: Although several reports have been published on role and timing of endoscopy in the treatment of acute biliary pancreatitis (ABP), there are still some controversial in this subject. In clinical practice the decision to perform an endoscopic retrograde cholangiopancreatography is often based on biochemical and radiological criteria despite they already have been shown to be unreliable predictors of common bile duct (CBD) stone presence. Both magnetic resonance cholangiopancreatography and endoscopic ultrasonography (EUS) are now indicated as the best noninvasive imaging methods for CBD stone detection. Early EUS in ABP allows, if appropriate, immediate endoscopic treatment and significant spare of unnecessary operative procedures thus reducing possible related complications.