Early ductal decompression prevents the progression of biliary pancreatitis: An experimental study in the opossum

Michael Rünzi, Ashok Saluja, Markus M. Lerch, Rajinder Dawra, Hirokazu Nishino, Michael L. Steer

Research output: Contribution to journalArticle

92 Scopus citations

Abstract

Background: The value of early endoscopic or surgical interventions to remove bile duct stones and decompress the biliopancreatic ductal system in gallstone pancreatitis is controversial. Methods: To evaluate this issue, acute hemorrhagic necrotizing pancreatitis was induced in opossums by obstructing the biliopancreatic ductal system with a balloon catheter for 1, 3, or 5 days. Results: A progressive increase in the severity of pancreatitis, as manifested by inflammation, fat necrosis, hemorrhage, acinar cell vacuolization, in vitro lactate dehydrogenase release, and acinar cell necrosis, was noted in these obstructed animals. In contrast, decompression of the obstructed ductal system by removal of the balloon catheter after 1 or 3 days prevented the increase in severity of these parameters of pancreatic injury. Conclusions: We conclude that the severity of biliary pancreatitis in this model is dependent upon the duration of ductal obstruction and that decompression of the ductal system can prevent progression of the disease. These observations support the practice of early attempts to remove obstructing stones in clinical gallstone pancreatitis.

Original languageEnglish (US)
Pages (from-to)157-164
Number of pages8
JournalGastroenterology
Volume105
Issue number1
DOIs
StatePublished - Jul 1993
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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