Article révisé par les pairs
Résumé : The authors have previously proposed endoscopic retrograde cholangio-pancreatography as a technic to be used systematically in acute pancreatitis; it offers a precise diagnosis of microlithiasis and a possibility of an immediate endoscopic treatment. They have studied the pancreatographic patterns in 355 cases of clinical acute pancreatitis; the pancreatogram allows the diagnosis of chronic pancreatitis in acute phase in 1/3 of the patients; necrosis is present in 12% of the 240 patients without any radiological signs of chronic pancreatic disease. Computerized axial tomography gives a precise definition of the extrapancreatic extension of the necrosis; the ultrasound technic is better for the late complications of acute pancreatitis. The authors consider that these 3 examination technics must be performed at admission or/and be part of the immediate preparation before surgery.