ERCP Alone Doesn’t Finish the Job
Selin and colleagues’ nationwide Swedish cohort of 9,593 first-episode gallstone pancreatitis patients quantifies the price of incomplete care. Same-admission cholecystectomy was followed by recurrent pancreatitis in 3.4% of patients; no intervention, in 17.5%. Most striking is the ERCP-only group: sphincterotomy without cholecystectomy left patients with a 19.9% rate of subsequent gallstone complications and an early recurrence peak within two weeks. Yet only 28.7% of patients nationwide received index-admission surgery. The authors’ conclusion supports “prioritizing same-admission cholecystectomy in all individuals” fit for surgery — a finding that strengthens the case for definitive, single-admission management of the entire biliary problem, duct included.
Citation
Selin D, Oskarsson V, Maret-Ouda J, et al. Cholecystectomy vs endoscopic retrograde cholangiopancreatography or no intervention after gallstone-related acute pancreatitis. JAMA Surg. Published online June 24, 2026. doi:10.1001/jamasurg.2026.2168
