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. 1990 Sep;31(9):1073–1075. doi: 10.1136/gut.31.9.1073

Pancreatic duct abnormalities in gall stone disease: an endoscopic retrograde cholangiopancreatographic study.

S P Misra 1, P Gulati 1, V Choudhary 1, B S Anand 1
PMCID: PMC1378672  PMID: 2210455

Abstract

This study was carried out to assess pancreatic duct abnormalities in gall stone disease. Endoscopic retrograde cholangiopancreatograms of 50 patients with gall stone disease were analysed and the results compared with those obtained in 33 patients investigated for cholestatic jaundice who were found to have a normal biliary tree (control group). Abnormal pancreatograms were obtained in 24 (48%) patients with gall stone disease and in only two (6%) in the control group; the differences were statistically significant (chi 2 = 14.3; p less than 0.001). The patients in the control group showed mild abnormalities as did those in the gall stone group. The frequency of various abnormalities were: mild 16 (32%), moderate five (10%), and severe three (6%). Pancreatic duct abnormalities were more severe and occurred more frequently in patients with gall stones who had stones in the biliary tree than in patients with a normal biliary tree (postcholecystectomy patients, 55% v 25%) but the difference between the two groups just failed to be significant (chi 2 = 3.34). In conclusion, nearly half of all patients with gall stone disease have pancreatic duct abnormalities and in 16% these were severe enough to be labelled as chronic pancreatitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acosta J. M., Ledesma C. L. Gallstone migration as a cause of acute pancreatitis. N Engl J Med. 1974 Feb 28;290(9):484–487. doi: 10.1056/NEJM197402282900904. [DOI] [PubMed] [Google Scholar]
  2. Axon A. T., Ashton M. G., Lintott D. J. Pancreatogram changes in patients with calculous biliary disease. Br J Surg. 1979 Jul;66(7):466–470. doi: 10.1002/bjs.1800660705. [DOI] [PubMed] [Google Scholar]
  3. Axon A. T., Classen M., Cotton P. B., Cremer M., Freeny P. C., Lees W. R. Pancreatography in chronic pancreatitis: international definitions. Gut. 1984 Oct;25(10):1107–1112. doi: 10.1136/gut.25.10.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bank S. Chronic pancreatitis: clinical features and medical management. Am J Gastroenterol. 1986 Mar;81(3):153–167. [PubMed] [Google Scholar]
  5. Dixon J. A., Hillam J. D. Surgical treatment of biliary tract disease associated with acute pancreatitis. Am J Surg. 1970 Sep;120(3):371–375. [PubMed] [Google Scholar]
  6. Freund H., Pfeffermann R., Durst A. L., Rabinovici N. Gallstone pancreatitis. Exploration of the biliary system in acute and recurrent pancreatitis. Arch Surg. 1976 Oct;111(10):1106–1107. doi: 10.1001/archsurg.1976.01360280064010. [DOI] [PubMed] [Google Scholar]
  7. GLENN F., FREY C. RE-EVALUATION OF THE TREATMENT OF PANCREATITIS ASSOCIATED WITH BILIARY TRACT DISEASE. Ann Surg. 1964 Oct;160:723–736. doi: 10.1097/00000658-196410000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hamilton I., Bradley P., Lintott D. J., McMahon M. J., Axon A. T. Endoscopic retrograde cholangiopancreatography in the investigation and management of patients after acute pancreatitis. Br J Surg. 1982 Sep;69(9):504–506. doi: 10.1002/bjs.1800690903. [DOI] [PubMed] [Google Scholar]
  9. Imrie C. W., Whyte A. S. A prospective study of acute pancreatitis. Br J Surg. 1975 Jun;62(6):490–494. doi: 10.1002/bjs.1800620615. [DOI] [PubMed] [Google Scholar]
  10. Jones B. A., Salsberg B. B., Mehta M. H., Bohnen J. M. Common pancreaticobiliary channels and their relationship to gallstone size in gallstone pancreatitis. Ann Surg. 1987 Feb;205(2):123–125. doi: 10.1097/00000658-198702000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kelly T. R. Gallstone pancreatitis: pathophysiology. Surgery. 1976 Oct;80(4):488–492. [PubMed] [Google Scholar]
  12. Kelly T. R., Swaney P. E. Gallstone pancreatitis: the second time around. Surgery. 1982 Oct;92(4):571–575. [PubMed] [Google Scholar]
  13. Misra S. P., Gulati P., Thorat V. K., Vij J. C., Anand B. S. Pancreaticobiliary ductal union in biliary diseases. An endoscopic retrograde cholangiopancreatographic study. Gastroenterology. 1989 Mar;96(3):907–912. [PubMed] [Google Scholar]
  14. Nagai H., Ohtsubo K. Pancreatic lithiasis in the aged. Its clinicopathology and pathogenesis. Gastroenterology. 1984 Feb;86(2):331–338. [PubMed] [Google Scholar]
  15. Ong G. B., Lam K. H., Lam S. K., Lim T. K., Wong J. Acute pancreatitis in Hong Kong. Br J Surg. 1979 Jun;66(6):398–403. doi: 10.1002/bjs.1800660607. [DOI] [PubMed] [Google Scholar]
  16. Ranson J. H. The timing of biliary surgery in acute pancreatitis. Ann Surg. 1979 May;189(5):654–663. doi: 10.1097/00000658-197905000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Satake K., Umeyama K., Kobayashi K., Mitani E., Tatsumi S., Yamamoto S., Howard J. M. An evaluation of endoscopic pancreatocholangiography in surgical patients. Surg Gynecol Obstet. 1975 Mar;140(3):349–354. [PubMed] [Google Scholar]
  18. Schmitz-Moormann P., Riedel R., Ihm P. Morphometrische Untersuchung der Kaliberschwankungen am normalen Ductus pancreaticus major. Z Gastroenterol. 1981 Jun;19(6):299–306. [PubMed] [Google Scholar]

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