Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2024; 30(7): 614-623
Published online Feb 21, 2024. doi: 10.3748/wjg.v30.i7.614
Pathophysiology of severe gallstone pancreatitis: A new paradigm
Masatoshi Isogai
Masatoshi Isogai, Clinic IB, Ibi 501-0614, Gifu, Japan
Masatoshi Isogai, Department of Surgery, Nawa Hospital, Ogaki 503-0893, Gifu, Japan
Author contributions: Isogai M conceived the idea for the manuscript, reviewed the literature, drafted the manuscript, and approved the final version of the article.
Conflict-of-interest statement: There is no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Masatoshi Isogai, MD, Director, Clinic IB, No. 657-1 Ibigawa-cho Nagara, Ibi 501-0614, Gifu, Japan. masatoshi.isogai@gmail.com
Received: October 18, 2023
Peer-review started: October 18, 2023
First decision: December 11, 2023
Revised: December 16, 2023
Accepted: January 18, 2024
Article in press: January 18, 2024
Published online: February 21, 2024
Core Tip

Core Tip: Gallstones represent the main cause of acute pancreatitis globally, and awareness of the etiology and pathogenesis of severe disease is mandatory. Based on the present study aimed to clarify the pathophysiology of severe disease from clinicopathological and historical points of view, severe gallstone pancreatitis may be a hybrid disease with pathology polarized between acute cholangitis and necrotizing pancreatitis in which the severity of hepatobiliary and pancreatic lesions is inversely related to the presence or absence of impacted ampullary stones with biliopancreatic obstruction. When the status of the stones is determined, the clinical course and outcome can be predicted.