CLINICAL SIGNIFICANCE OF COMMON BILE DUCT STENOSIS IN CHRONIC PANCREATITIS

Abstract

We evaluated the clinical significance of common bile duct stenosis occurring with chronic pancreatitis, comparing the exocrine and endocrine functions and the pancreatograms of patients with stenosis and those without stenosis. Common bile duct stenosis was discovered in 39 out of 102 patients (38%) with chronic pancreatitis in which cholangiograms were available. Generally, a large number of patients with stenosis showed exocrine and endocrine function more impaired than those without stenosis, and the occurence of common bile duct stenosis increased as the classification according to grade based on pancreatogram advanced. On the other hand, 15 out of 44 patients who could not be diagnosed as having advanced pancreatitis using the pancreatogram as the only criterion also showed common bile duct stenosis, and their pancreatic exocrine and endocrine functions usually were revealed as more impaired when compaired with those of 29 other patients without stenosis. As mentioned above, on the basis of the pancreatogram alone, the grade of chronic pancreatitis is occasionally regarded as lower in some patients. In such cases, it would be important to acertain whether or not there is common bile duct stenosis.