Indication and Optimal Timing of ERCP in Acute Pancreatitis

Acute pancreatitis is an inflammatory disease of the pancreas that can cause local injury sometimes accompanied by a severe systemic inflammatory response which can lead to multiple organ dysfunction. The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute biliary pancreatitis of biliary origin has been the focus of much research in recent years. Taking into account this finding as well as the fact that ERCP is associated with a significant risk of procedure-related complications (including a mortality rate of around 1%), accurate selection of the appropriate candidates for intervention as well as the optimal timing for endoscopy is very important. Local expertise, including the availability of advanced surgical and radiological techniques, is also a very important factor in deciding the best treatment modality, since a multidisciplinary approach is very important for the successful treatment of severe cases of pancreatitis.