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. 1977 Mar;18(3):196–201. doi: 10.1136/gut.18.3.196

Chronic pancreatitis: a cause of cholestasis.

J Scott, J A Summerfield, E Elias, R Dick, S Sherlock
PMCID: PMC1411390  PMID: 856677

Abstract

The bile ducts were visualised using endoscopic retrograde cholangiopancreatography (ERCP), percutaneous or intravenous cholangiography in 38 patients with non-gallstone chronic pancreatitis. Stenosis of the intrapancreatic portion of the distal common bile duct was demonstrated in 11 patients. Ten of the 11 developed transient cholestasis during exacerbations of their chronic pancreatitis. In six cholestasis eventually persisted requiring surgical relief. Secondary biliary cirrhosis was present in one patient. No evidence of pancreatic carcinoma was found in the patients explored surgically. Ten of the patients are alive more than one year after diagnosis.Chronic pancreatitis was of alcoholic aetiology in 10 of the patients with biliary stenosis. Cholestasis and biliary stricture are common but poorly recognised complications of non-gallstone chronic pancreatitis, especially when pancreatitis is severe and due to alcohol.

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Selected References

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  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. BECKETT A. G., LIVINGSTONE A. V., HILL K. R. Acute alcoholic hepatitis. Br Med J. 1961 Oct 28;2(5260):1113–1119. doi: 10.1136/bmj.2.5260.1113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BOCKUS H. L., KALSER M. H., ROTH J. L., BOGOCH A. L., STEIN G. Clinical features of acute inflammation of the pancreas; analysis of ninety-four attacks in seventy-eight patients. AMA Arch Intern Med. 1955 Sep;96(3):308–321. doi: 10.1001/archinte.1955.00250140030003. [DOI] [PubMed] [Google Scholar]
  4. COFFEY R. J. The relationship of acute and chronic cholecystitis to acute pancreatitis. South Med J. 1954 May;47(5):448–451. doi: 10.1097/00007611-195405000-00007. [DOI] [PubMed] [Google Scholar]
  5. DUVAL M. K., Jr Pancreaticojejunostomy for chronic pancreatitis. Surgery. 1957 Jun;41(6):1019–1028. [PubMed] [Google Scholar]
  6. GOLDBERG M., THOMPSON C. M. Acute fatty metamorphosis of the liver. Ann Intern Med. 1961 Sep;55:416–432. doi: 10.7326/0003-4819-55-3-416. [DOI] [PubMed] [Google Scholar]
  7. Howard J. M., Nedwich A. Correlation of the histologic observations and operative findings in patients with chronic pancreatitis. Surg Gynecol Obstet. 1971 Mar;132(3):387–395. [PubMed] [Google Scholar]
  8. Howat H. T. Chronic pancreatitis: medical aspects. Postgrad Med J. 1968 Sep;44(515):733–736. doi: 10.1136/pgmj.44.515.733. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. James O., Agnew J. E., Bouchier I. A. Chronic pancreatitis in England: a changing picture? Br Med J. 1974 Apr 6;2(5909):34–38. doi: 10.1136/bmj.2.5909.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. James O. The Lundh test. Gut. 1973 Jul;14(7):582–591. doi: 10.1136/gut.14.7.582. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kasugai T., Kuno N., Kizu M. Endoscopic pancreatocholangiography with special reference to manometric method. Med J Aust. 1973 Oct 13;2(15):717–725. doi: 10.5694/j.1326-5377.1973.tb129743.x. [DOI] [PubMed] [Google Scholar]
  12. 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]
  13. Kasugai T., Kuno N., Kobayashi S., Hattori K. Endoscopic pancreatocholangiography. I. The normal endoscopic pancreatocholangiogram. Gastroenterology. 1972 Aug;63(2):217–226. [PubMed] [Google Scholar]
  14. McCollum W. B., Jordan P. H. Obstructive jaundice in patients with pancreatitis without associated biliary tract disease. Ann Surg. 1975 Aug;182(2):116–120. doi: 10.1097/00000658-197508000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Nakamura K., Sarles H., Payan H. Three-dimensional reconstruction of the pancreatic ducts in chronic pancreatitis. Gastroenterology. 1972 May;62(5):942–949. [PubMed] [Google Scholar]
  16. Okuda K., Tanikawa K., Emura T., Kuratomi S., Jinnouchi S. Nonsurgical, percutaneous transhepatic cholangiography--diagnostic significance in medical problems of the liver. Am J Dig Dis. 1974 Jan;19(1):21–36. doi: 10.1007/BF01073350. [DOI] [PubMed] [Google Scholar]
  17. Owor R. Chronic pancreatic disease: a common cause of obstructive jaundice in Ugandan Africans? East Afr Med J. 1972 Aug;49(8):614–619. [PubMed] [Google Scholar]
  18. Rohrmann C. A., Silvis S. E., Vennes J. A. Evaluation of the endoscopic pancreatogram. Radiology. 1974 Nov;113(2):297–304. doi: 10.1148/113.2.297. [DOI] [PubMed] [Google Scholar]
  19. Sarles H. Chronic calcifying pancreatitis--chronic alcoholic pancreatitis. Gastroenterology. 1974 Apr;66(4):604–616. [PubMed] [Google Scholar]
  20. Snape W. J., Jr, Long W. B., Trotman B. W., Marin G. A., Czaja A. J. Marked alkaline phosphatase elevation with partial common bile duct obstruction due to calcific pancreatitis. Gastroenterology. 1976 Jan;70(1):70–73. [PubMed] [Google Scholar]
  21. WEINSTEIN B. R., KORN R. J., ZIMMERMAN H. J. Obstructive jaundice as a complication of pancreatis. Ann Intern Med. 1963 Feb;58:245–258. doi: 10.7326/0003-4819-58-2-245. [DOI] [PubMed] [Google Scholar]
  22. Warshaw A. L., Schapiro R. H., Ferrucci J. T., Jr, Galdabini J. J. Persistent obstructive jaundice, cholangitis, and biliary cirrhosis due to common bile duct stenosis in chronic pancreatitis. Gastroenterology. 1976 Apr;70(4):562–567. [PubMed] [Google Scholar]
  23. Youngs G. R., Agnew J. E., Levin G. E., Bouchier I. A. Radioselenium in duodenal aspirate as an assessment of pancreatic exocrine function. Br Med J. 1971 May 1;2(5756):252–255. doi: 10.1136/bmj.2.5756.252. [DOI] [PMC free article] [PubMed] [Google Scholar]

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