Proposal of the term “gallstone cholangiopancreatitis” to specify gallstone pancreatitis that needs urgent endoscopic retrograde cholangiopancreatography

Figure 1 Subdivisions of gallstone pancreatitis with severe disease into gallstone cholangiopancreatitis and gallstone necrotizing pancreatitis. A: Gallstone cholangiopancreatitis with persistent ampullary stone impaction and ascending acute cholangitis complicated with minimal or mild pancreatic inflammation due to biliopancreatic obstruction; B: Gallstone necrotizing pancreatitis caused by the reflux of bile or duodenal contents into the pancreas (P), not complicated by acute biliary tract disease due to the passage of stones. L: Liver; BD: Bile duct; GB: Gallbladder; PD: Main pancreatic duct.

Figure 2 The algorithm for the diagnosis and initial treatment of gallstone pancreatitis. AP: Acute pancreatitis; CECT: Contrast-enhanced computed tomography; CP: Cholangiopancreatitis; ERCP: Endoscopic retrograde cholangiopancreatography; ES: Endoscopic sphincterotomy; NP: Necrotizing pancreatitis.