Is Pancreatitis Caused by Biliary Disease Likely to Recur After Treatment?

Patients suffering from biliary pancreatitis often experience a high recurrence rate if the underlying cause is not properly addressed. To significantly reduce the likelihood of recurrence, treatment should focus on the root cause of the pancreatitis. In cases where the condition is triggered by biliary stones — such as gallbladder stones, common bile duct stones, or intrahepatic bile duct stones — removing these stones typically leads to a marked decrease in the risk of recurrence.

However, for patients with pancreatitis caused by abnormalities at the biliopancreatic junction, the recurrence rate may remain high even after surgical intervention. Even after removing gallstones or performing procedures such as cholecystectomy or stone extraction from the bile ducts, the recurrence rate can still be significant. This is because the core pathological cause of pancreatitis may not have been fully resolved. Conditions such as stenotic papillitis, sclerosing papillitis, long papillary protrusion, and peripapillary diverticula, as well as abnormal confluence of the bile and pancreatic ducts — whether high or low — can all contribute to recurrent episodes.

Effective treatment for these conditions often involves ERCP (endoscopic retrograde cholangiopancreatography), a minimally invasive procedure using a duodenoscope. This technique can help clear obstructions in both the pancreatic and bile ducts. For example, in cases of a long papilla, the outflow tract can be surgically adjusted to shorten it, and biliary-pancreatic separation can be performed to prevent further complications.

By addressing the specific underlying causes of pancreatitis through targeted interventions, the recurrence rate can be significantly reduced, and in some cases, completely eliminated. Therefore, accurate diagnosis and tailored treatment based on the etiology are crucial for long-term management and improved patient outcomes.