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Acute pancreatitis is sometimes caused by gallstones that block the duct through which digestive enzymes leave the pancreas. ���ϸ����� Langone surgeons can perform an endoscopic procedure to remove the blockage, allowing the pancreas to function normally.

Our doctors may also perform surgery to relieve severe complications of acute pancreatitis, such as infection and tissue death, also called necrosis.

Endoscopic Retrograde Cholangiopancreatography

For acute pancreatitis caused by gallstones lodged in the common bile duct, doctors may perform a procedure called endoscopic retrograde cholangiopancreatography to remove the stones and prevent further inflammation in the pancreas.

During the procedure, your doctor glides an endoscope with a tiny video camera on the end through the mouth, down the throat and stomach, and into the small intestine, adjacent to the pancreas.

Using the endoscope, your doctor finds an opening in the intestine that connects to the pancreatic and bile ducts. He or she places a catheter or small tube in the opening and injects a contrast dye. The dye enhances images of the pancreatic and bile ducts on X-rays. This helps the doctor identify the gallstones causing the blockage so that they can be removed.

The doctor then makes a small incision where the pancreatic duct and bile duct meet—an area called the ampulla of Vater—and inserts surgical tools, such as a balloon catheter or a basket, to retrieve the stone or stones. If there are many gallstones in the duct, sometimes doctors need to perform two procedures to remove all of them. They may place a temporary plastic tube called a stent in the duct to relieve the obstruction in between procedures.

When this procedure is performed, our specialists often also recommend a cholecystectomy, in which surgeons remove the gallbladder. This prevents pancreatitis from recurring.

After an endoscopic retrograde cholangiopancreatography, you may remain in the hospital for three to four hours as you recover. Immediately after the procedure, you may feel bloated or nauseated. Your doctor may advise you to rest for the remainder of the day, but most people can resume normal activities the following day.

Debridement and Drainage

If acute pancreatitis has caused severe complications, such as an infection that doesn’t respond to antibiotics, ���ϸ����� Langone surgeons may perform a debridement and drainage procedure to remove infected pancreatic tissue or necrosis. This procedure also allows doctors to drain any fluid from the pancreas that has accumulated because of an infection. They may create a new drainage pathway in the pancreas to restore normal function.

Doctors at ���ϸ����� Langone can perform debridement and drainage using laparoscopic surgical techniques, traditional open surgery, or robotic-assisted surgery. The technique your surgeon uses depends on where the damage occurs in the pancreas, as well as your health.

Pancreatic surgeons at ���ϸ����� Langone also specialize in advanced techniques, such as video-assisted retroperitoneal debridement, which involves operating through the back of the body to repair damage to the distal, or tail end, of the pancreas.