Gallstone pancreatitis: an update.

Gallstone pancreatitis is one of the more prevalent causes of pancreatitis. It accounts for more than two thirds of the cases of acute pancreatitis worldwide and 25 to 45% of the cases in the United States. Furthermore, it is one of the most important treatable causes of pancreatitis. These two important features of the disease make its recognition and proper management critical. Key to recognition and proper management of gallstone pancreatitis is understanding that this disease can exist in three different forms. It can exist as impacted gallstone pancreatitis, as nonimpacted gallstone pancreatitis, or as sludge-related pancreatitis. Each of these forms of the disease will have some unique features relating to their pathogenesis, diagnosis, and treatment. This update focuses on "take-home" features that will allow (1) clinical differentiation between the three forms of the disease and (2) understanding the unique features that relate to their pathogenesis, diagnosis, and management.