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. 1995 May;36(5):761–765. doi: 10.1136/gut.36.5.761

Is biliary lithiasis associated with pancreatographic changes?

M Barthet 1, C Affriat 1, J P Bernard 1, P Berthezene 1, J C Dagorn 1, J Sahel 1
PMCID: PMC1382683  PMID: 7797128

Abstract

The aetiological role of biliary lithiasis for chronic pancreatitis remains controversial. Previous studies based on pancreatographic studies reported changes in the pancreatic duct system caused by biliary lithiasis. This study analysed retrospectively the endoscopic retrograde cholangiopancreatography of 165 patients presenting with biliary lithiasis and of 53 controls. Among the 165 patients, 113 had choledochal stones (53 with gall bladder stones, 50 had had a cholecystectomy, 10 with a normal gall bladder), 35 had gall bladder stones without choledochal stones, 17 had cholecystectomy for gall bladder stones. Pancreatograms were analysed by measuring the diameter of the pancreatic duct in the head, the body, and the tail of the pancreas, and evaluating the regularity of the main pancreatic duct and the presence of stenosis, the regularity or the dilatation of secondary ducts, and the presence of cysts. In addition, we established a score, based on the above parameters, by which pancreatograms were classified as normal or with mild, intermediate, moderate or severe abnormalities. A multivariate analysis (stepwise multiple discriminant analysis) was performed for age, sex, presence of gall stones, presence of choledochal stones. Patients were comparable with controls for sex, alcohol consumption but were younger (55 v 68 years, p < 0.01). In patients and in controls, the frequency of pancreatographic abnormalities increased significantly with age. The pancreatographic features of patients and controls were not significantly different. In the multivariate analysis, age was the only factor with significant predicting value for pancreatographic abnormalities. In conclusion, biliary lithiasis in itself is not an aetiological factor for chronic pancreatitis, older age being responsible for the abnormalities seen by pancreatography of patients with biliary lithiasis.

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Selected References

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  1. Anand B. S., Vij J. C., Mac H. S., Chowdhury V., Kumar A. Effect of aging on the pancreatic ducts: a study based on endoscopic retrograde pancreatography. Gastrointest Endosc. 1989 May-Jun;35(3):210–213. doi: 10.1016/s0016-5107(89)72760-7. [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. Bourliere M., Barthet M., Berthezene P., Durbec J. P., Sarles H. Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis? Gut. 1991 Nov;32(11):1392–1395. doi: 10.1136/gut.32.11.1392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cotton P. B. Cannulation of the papilla of Vater by endoscopy and retrograde cholangiopancreatography (ERCP). Gut. 1972 Dec;13(12):1014–1025. doi: 10.1136/gut.13.12.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Jones S. N., McNeil N. I., Lees W. R. The interpretation of retrograde pancreatography in the elderly. Clin Radiol. 1989 Jul;40(4):393–396. doi: 10.1016/s0009-9260(89)80132-1. [DOI] [PubMed] [Google Scholar]
  7. Kasugai T., Kuno N., Kizu M., Kobayashi S., Hattori K. Endoscopic pancreatocholangiography. II. The pathological endoscopic pancreatocholangiogram. Gastroenterology. 1972 Aug;63(2):227–234. [PubMed] [Google Scholar]
  8. Kreel L., Sandin B. Changes in pancreatic morphology associated with aging. Gut. 1973 Dec;14(12):962–970. doi: 10.1136/gut.14.12.962. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Misra S. P., Dwivedi M. Do gallstones cause chronic pancreatitis? Int J Pancreatol. 1991 Sep;10(1):97–102. doi: 10.1007/BF02924257. [DOI] [PubMed] [Google Scholar]
  10. Misra S. P., Gulati P., Choudhary V., Anand B. S. Pancreatic duct abnormalities in gall stone disease: an endoscopic retrograde cholangiopancreatographic study. Gut. 1990 Sep;31(9):1073–1075. doi: 10.1136/gut.31.9.1073. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Nagai H., Ohtsubo K. Pancreatic lithiasis in the aged. Its clinicopathology and pathogenesis. Gastroenterology. 1984 Feb;86(2):331–338. [PubMed] [Google Scholar]
  12. Neoptolemos J. P., Carr-Locke D. L., Kelly K. A. Factors affecting the diameters of the common bile duct and pancreatic duct using endoscopic retrograde cholangiopancreatography. Hepatogastroenterology. 1991 Jun;38(3):243–247. [PubMed] [Google Scholar]
  13. 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]
  14. Stamm B. H. Incidence and diagnostic significance of minor pathologic changes in the adult pancreas at autopsy: a systematic study of 112 autopsies in patients without known pancreatic disease. Hum Pathol. 1984 Jul;15(7):677–683. doi: 10.1016/s0046-8177(84)80294-4. [DOI] [PubMed] [Google Scholar]
  15. Varley P. F., Rohrmann C. A., Jr, Silvis S. E., Vennes J. A. The normal endoscopic pancreatogram. Radiology. 1976 Feb;118(2):295–300. doi: 10.1148/118.2.295. [DOI] [PubMed] [Google Scholar]

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