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Cholangitis of Pancreatitis? Does the Angiotensin-Converting Enzyme Genotype Favor Either? Acute cholangitis and pancreatitis are serious complications of gallstones, with considerable morbidity and mortality. Angiotensin-converting enzyme (ACE) is an exopeptidase that is important in regulating blood pressure, metabolizing bradykinin and in maintaining an inflammatory response. To determine whether the ACE genotype determines occurrence of cholangitis or pancreatitis we examined ACE I/D genotypes in 31 patients who had cholangitis, 44 patients with biliary pancreatitis and 157 healthy individuals. The patients had been hospitalized at the Department and Intensive Care Faculty of Medicine, Ege University, Izmir, Turkey. The patients were recalled 4 years later and their prognosis was evaluated. The ACE II genotype was found at a higher frequency in the cholangitis and biliary pancreatitis patients when compared with the healthy subjects (p <0.05). There was no significant difference between cholangitis and biliary pancreatitis cases regarding the genotype and allele distribution (p >0.05). Recurrence of infection occurred more frequently in the patients with the DD genotype, although it was not significant according to the first assessment (p >0.05). The ACE gene polymorphism did not seem to favor development of either cholangitis or pancreatitis.