2005 Volume 20 Issue 2 Pages 79-84
The clinical features of choledocholithiasis were studied in a consecutive series of 1,117 cases including 441 with stones passed spontaneously, treated at our department during the last 10 years. Serum pancreatic enzyme was elevated in 218 (19.5%) cases, and 216 (20.8%) of 1,036 patients had attacks of abdominal pain. However, severe pancreatitis was in only diagnosed in 24 patients, representing 11% of 218 patients with elevated pancreatic enzymes, 2.1% of total 1,117 cases. In 137 (62.8%) of 218 with elevated pancreatic enzymes, stones had passed spontaneously, and in 26 (11.9%) patients, the stone diameter was less than or equal to 5 mm. Elevation of pancreatic enzymes was seen in 31.1% of 441 cases with passed stones. These results suggest that acute pancreatitis as a complication of choledocholithiasis, in particular, with small stones, is not rare (about 20%), though it rarely present as severe pancreatitis.
