What is the most emergent treatment for gallstone pancreatitis?

ERCP: Most cases of pancreatitis are mild & self-limiting. However, if severe (or with a strong suspicion of common bile duct stones), endoscopic removal of the cbd stone (endoscopic retrograde cholangiopancreatography) may improve the outcome. Eventually, a cholecystectomy will be necessary to prevent future episodes.

ERCP/cholecystectomy: Gallstone pancreatitis is due to small to mediun size stones from the gall bladder traveling down the common bille duct and creating the blockege. Treatment is to remove blocking stones which can be aquiered by ERCP or common bille duct exploration. Than the source of the gall stones should be removed - gall bladder- to prevent further episodes of pancreatitis.

Supportive care: Majority of patients get better with supportive care (hydration, pain and nausea meds). No emergency procedure needs to be done unless, pancreas and liver numbers are not coming down. In this case ERCP is needed to remove the impacted stone.

Ercp : Briefly, ERCP and sphincterotomy to retreive the stone. Course of IV antibiotics before procedure. Then, after symptoms improve and a course of antibiotics, a lap chole can be performed as an elective procedure.

Observation and: Medical care. Here most gastroenterologists will not approach a bile duct stone in the face of acute pancreatitis for fear of making the condition worse. Usually hospitalization, pain medication, maybe antibiotics first. More than 80% improve with medical support. Then ERCP if a bile duct stone remains or surgery for laparoscopic gb after pancreatitis has resolved.