Biliary Pancreatitis

When the pancreas becomes inflammed and swollen, it is called pancreatitis. Gallstones are one of the most common causes of pancreatitis. When inflammation of the pancreas is caused by a gallstone, it is called biliary pancreatitis or gallstone pancreatitis. This is usually caused by a gallstone that goes far into the common bile duct and blocks the pancreatic duct which is nearby.


Some of the common symptoms are severe pain in the abdomen that can radiate to the back, fever, nausea, vomiting, change in the color of stool, change in the color of urine or jaundice (yellowing of the skin or eyes).


There are many studies that can help diagnose pancreatitis. Lab work or a CAT (computerized axial tomography) scan are the most common ways to diagnose pancreatitis. Other studies such as an ultrasound or MRCP (magnetic resonance cholangiopancreatography) can help find out if a gallstone is the cause. Different studies are better for different situations and your doctor can help order the correct test.


If a patient has biliary pancreatitis, he/she is usually admitted to the hospital and treated with intravenous (IV) fluids, bowel rest (nothing to eat or drink) and sometimes antibiotics. If gallstones are the cause, the stones must be removed from the bile ducts and the gallbladder should also be surgically removed. The inflammation of the pancreas must get better before gallbladder removal surgery. If the gallbladder is not removed, there is a risk the patient could have another attack of biliary pancreatitis in the future.

The stones in the common bile duct can be removed with a procedure called an ERCP (endoscopic retrograde cholangiopancreatography) which is performed by a gastroenterologist. Surgical removal of the gallbladder by a surgeon (cholecystectomy) can be performed before or after the ERCP. Sometimes contrast dye is used in the operating room to help see if there are any stones in the common bile duct. This is called an intra-operative cholangiogram and can help see if gallstones are causing a blockage. If patients are not healthy enough for surgery, then placement of a drainage tube into the gallbladder is another treatment performed by an interventional radiologist.