Stenosis of the common bile duct in chronic pancreatitis

Abstract

The incidence of common bile duct stenosis in patients with chronic pancreatitis was studied in a consecutive series of patients admitted for endoscopic retrograde cholangiopancreatography (ERCP). Thirty-six out of 79 patients (46 per cent) with moderate or advanced chronic pancreatitis as defined by radiological criteria were found to have a stenosis of the intrapancreatic portion of the common bile duct. There were no age or sex differences between the patients with and without biliary stenosis, but significantly more patients with stenosis had advanced chronic pancreatitis. In about two-thirds of the patients the stenosis was smooth, symmetrical and tapering. In the remaining cases, a shorter stricture of the hour-glass type was found. A complete obstruction was never seen. About one-half of the patients with bile duct stenosis were icteric at the time of the investigation. The jaundice resolved spontaneously in all but 1 patient in 3-42 (median 14) days. Stenosis of the common bile duct is a frequent complication of chronic pancreatitis, but biliary-enteric bypass operation seems to be unnecessary in the great majority of the patients.

Chronic pancreatitis. Multicentre prospective data collection and analysis by the Hungarian Pancreatic Study Group

“…In stage B of chronic pancreatitis, development of common bile duct stricture (CBS) is expected in 3-46% of cases [33][34][35][36][37][38][39][40]; in our cohort, 11% of the patients suffered from jaundice.…”

Pathologico-Anatomic Categories of Choledochal End-Piece Stenosis Due to Chronic Pancreatitis and Clinical Significance

“…Whichever has possibility to cause choledochal endpiece stenosis and lead to obvious dilatation in proximal bile duct, as long as leision implicates pancreatic head. Its incidence rate is 3% -46% in patients with CP [5,[8][9][10][11][12][13][14]. The majority of the reports are about 25%.…”

“…The two methods can show whether there are stenosis, dilatation, stones as well as tumor, and can know state of intrahepatic and pancreatie duct. Stenotic segment of choledochus due to CP is usually longer than 34 mm (39 ± 5 mm), and most of them is smooth, symmetrical and grandually attenuated, a few unsmooth [7,8]. Diameter of dilatating proximal choledochus generally is within 25 mm.…”

“…Frey et al [8] had reported that 66% -100% lf patients with sphincterotomy to treat choledochal terminal stenosis due to cp often required to be reoperated so it should be carefal to choose operation program. Ideal choice is Roux-en-x-type choledochojejunestomy [28].…”

Treatment of Benign Biliary Strictures in Chronic Pancreatitis by Self-Expandable Metal Stents

“…The prevalence rates reported in the literature range from 3 to 45% [1][2][3]. This diversity results from the different definitions of CBD stenosis employed.…”