Abstract：Objective To assess the efficacy of early endoscopic retrograde cholangiopancreatography (ERCP) in the management of severe acute biliary pancreatitis (SABP) compared with conservative treatment.Methods SABP patients were divided into early endoscopic intervention group (EEI) and early conservative management group (ECM) after informed consent from July 2011 to July 2015 in this department. The following indexes, such as the white blood cell count (WBC), neutrophil percentage (N%), total bilirubin (TBIL), interleukin 6 (IL-6), C-reactive protein (CRP), calcitonin (PCT), abdominal pain relief time, duration of hospitalization and incidence of organ failure were compared between the two groups.Results The average duration of hospitalization[ (24.8±4.8)d vs (28.3±6.1)d] and the incidence of organ failure (30.2% vs 53.5%) in the EEI group were significantly lower than that in the ECM group, and the pain relief rate (83.7% vs 60.4%) was higher in the EEI group (P<0.05). The incidence of necrotic infection of the pancreas in ECM group was likely higher than that in EEI group (P=0.062). Indexes of WBC, N%, IL-6 and TBIL significantly decreased after ERCP intervention in the EEI group, and N%, PCT, IL-6, CRP and TBIL were lower after 1 week of treatment than that of post-ERCP. ECM group failed to decrease the indexes of WBC, N%, PCT, IL-6, CRP and TBIL after conservative treatment for 72 h. Patients undergoing ERCP in ECM group had significantly lower WBC, N%, IL-6 and TBIL than the indexes of 72 h after admission (P<0.05). Patients treated after 1 week without ERCP had no changes in N% PCT, IL-6 and CRP. ERCP related complications were not seen in both groups.Conclusions ERCP intervention in the early stage of SABP is safe, effective and feasible, and it can improve clinical symptoms and indexes, shorten the course of disease, and promote the recovery of SABP patients.
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