Clinic Study Of ERCP Combined Detection Of Biliary Microlithiasis In Diagnosis For Idiopathic Acute Pancreatitis

Objective: To evaluate the diagnosis of ERCP combined detection of biliary microlithiasis in idiopathic acute pancreatitis (IAP) .Methods: Select 105 patients who were diagnosed acute pancreatitis(AP) from January 2008 to January 2010,forty two patients were scanned with normal system when usual imaging system (such as CT, ultrasound,MRCP) can not find the etiology of idiopathic acute pancreatitis,and thirty patients among them received examination of diagnostic ERCP. For each patient , five ml of bile was collected. Half of the specimens(bile) were examined under polarized light microscopic immediately, another half of the bile were examined after incubated at 37℃for 24 hours. Three different slides were made from the sediments of incubated bile after centrifuged. These slides were examined for the positive rate of crystal count with a rectangular microscope (ordinary light and polarized light).Ninty patients from January 2006 to January 2008 were regard as control group. SPSS13.0 statistical software were applied to conduct the statistics process, when P<0.05 were of statistical significance. Results: The diagnostic accuracy of normal way for the cause of the AP was 55.5% (50/90), while the diagnostic accuracy of ERCP combined with biliary microlithiasis examination for the cause of AP was 87.5% (93/105). The difference was of statistical significance (P<0.05). There were higher diagnostic accuracy in the diagnosis of ERCP combined detection of biliary microlithiasis in idiopathic acute pancreatitis.Conclusion: 1. If the common means cannot find the cause of IAP, the ERCP may be conducted. 2. If the result of ERCP was negative , the BML could be taken to detected those patients. The combination of these two means may improve the diagnostic accuracy of IAP. 3. BML was a important potential cause of IAP. 4. ERCP combined BML undertaken under polarized light microscopic may improve the diagnostic accuracy of duct lithiasis, especially the diagnostic accuracy of bile microlithiasis in duct.