Open AccessThe Spectrum and Natural History of Common Bile Duct Stenosis in Chronic Alcohol-Induced Pancreatitis
Author(s) -
I Kalvaria,
P. C. Bornman,
I. N. Marks,
A. H. Girdwood,
Leslie Bank,
R. E. Kottler
Publication year - 1989
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198911000-00007
Subject(s) - medicine , pancreatitis , endoscopic retrograde cholangiopancreatography , common bile duct , jaundice , stenosis , gastroenterology , natural history , complication , pancreatic duct , bile duct , general surgery , surgery
Sixty patients with chronic alcohol-induced pancreatitis with endoscopic retrograde cholangiopancreatography evidence of common bile duct stenosis were studied to determine the clinical spectrum and natural history of this complication, as well as the indications for biliary bypass. In 17% of patients, common bile duct stenosis (CBDS) was an incidental finding at ERCP, while in the remaining cases pain and jaundice were the predominant symptoms in 35% and 48%, respectively. Biliary drainage was performed in 38% of patients for persistent or recurrent jaundice, cholangitis, and while undergoing pancreatic duct or cyst drainage procedures for pain. The benign nature of CBDS in chronic alcohol-induced pancreatitis (CAIP) in patients without persistent jaundice is emphasized. In particular, no histologically proved cases of secondary biliary cirrhosis were noted. The majority of patients with CBDS due to CAIP may be safely managed without biliary bypass but require close follow-up.