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Previous Volume 329:58-59 July 1, 1993 Number 1 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article by Fan, S.-T.

To the Editor: A problem with the study by Fan et al. (Jan. 28 issue)¹ is the authors' inability to distinguish reliably patients presenting with acute pancreatitis and secondary biliary obstruction from those presenting with primary biliary obstruction and sepsis. At least one of the patients randomly assigned to initial conservative treatment had a serum bilirubin concentration of 37.2 mg per deciliter. Patients who present with acute abdominal symptoms, fever, and leukocytosis should probably undergo emergency endoscopic retrograde cholangiopancreatography (ERCP), regardless of their serum amylase concentrations².

Furthermore, even in patients with unequivocal pancreatitis, potentially life-threatening biliary obstruction cannot always . . . [Full Text of this Article]

References

This article has been cited by other articles:

• de Virgilio, C., Verbin, C., Chang, L., Linder, S., Stabile, B. E., Klein, S. (1994). Gallstone Pancreatitis: The Role of Preoperative Endoscopic Retrograde Cholangiopancreatography. Arch Surg 129: 909-913 [Abstract]