To do or not to do an endoscopic retrograde cholangiopancreatography in acute biliary pancreatitis?

In 16 patients with acute biliary pancreatitis, we performed endoscopic retrograde cholangiopancreatography (ERCP) 10 to 14 days after onset of the attack. All patients had mild pancreatitis. In 10 patients with normal-appearing common bile duct (CBD) on ultrasonography, ERCP was normal also. In two patients with dilated CBD on ultrasonography, stones were found in the CBD on ERCP, sphincterotomy was performed, and the stones were extracted endoscopically. We think there is no need for preoperative ERCP in patients with mild attacks of biliary pancreatitis if the CBD appears undilated on ultrasonography.