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The spectrum of biliary tract obstruction from chronic pancreatitis.

Authors :
Aranha GV
Prinz RA
Freeark RJ
Greenlee HB
Source :
Archives of surgery (Chicago, Ill. : 1960) [Arch Surg] 1984 May; Vol. 119 (5), pp. 595-600.
Publication Year :
1984

Abstract

Fifty-one patients with chronic pancreatitis manifested distal common duct obstruction from fibrosis of pancreatitis. The cause of the pancreatitis was alcohol in most patients. An elevated serum alkaline phosphatase level was the most frequent abnormal laboratory finding. The serum bilirubin level elevation was never progressive; a rising and falling pattern was most often encountered. Percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography are the most useful diagnostic tests. An operation was performed on 47 patients and included choledochoduodenostomy in 16 patients, choledochojejunostomy in 19 patients, cholecystenteric anastomosis in seven patients, common bile duct exploration with T-tube drainage in three patients, and sphincteroplasty in two patients. Abdominal pain was lessened after operation in 40 of 44 patients who survived surgery. Two patients with T-tube drainage and two with cholecystenteric anastomosis required conversion operations to choledochoduodenostomies. Identification of associated pancreatic duct obstruction and dilatation, pseudocysts, and duodenal obstruction is important.

Details

Language :
English
ISSN :
0004-0010
Volume :
119
Issue :
5
Database :
MEDLINE
Journal :
Archives of surgery (Chicago, Ill. : 1960)
Publication Type :
Academic Journal
Accession number :
6712475
Full Text :
https://doi.org/10.1001/archsurg.1984.01390170091018