Biliary tract surgery was performed on 52 patients with gallstone pancreatitis. In those patients operated on during the acute phase of pancreatitis, the pancreas appeared to be either mildly or severely inflamed. In 35.7% of the patients operated on after the regression of symptoms of acute pancreatitis, the pancreas appeared grossly normal.
Although 94.2% and 21.1% of the patients had gallbladder and common bile duct stones, respectively, only 5.7% had impacted ampullary stones.
Cholecystectomy, operative cholangiography, and choledochostomy, when indicated, were routinely performed.
Since the natural history of gallstone pancreatitis is one of frequent recurrence, the correction of the biliary tract disease should be performed on the initial hospital admission. This operative policy has resulted in no mortality and only a 4% late incidence of recurrent acute pancreatitis in a 15-year follow-up period.