Pancreatic-duct reflux in patients with gallstone pancreatitis?
The pathogenesis of gallstone pancreatitis remains controversial and current thinking supports duodenopancreatic-duct reflux after the passage of a gallstone into the duodenum. A consecutive series of 292 operative cholangiograms was studied: the presence of pancreatic-duct reflux, common-bileduct diameter, presence of gallstones, and duodenal filling were recorded. Of 21 patients who had previously had an attack of acute pancreatitis 11 had pancreatic-duct reflux on their operative cholangiograms (52.4%), whereas of 271 patients who had no history of pancreatic disease, pancreatic-duct reflux occurred in 45 (16.6%). 6 of 11 men with pancreatic-duct reflux had previously had acute pancreatitis, compared with 5 of 45 women. There was no significant correlation between the presence of pancreatic-duct reflux and common-bileduct stones, bileduct diameter, absence of duodenal filling, or history of jaundice. The increased tendency for pancreatic-duct reflux to occur in patients with gallstone pancreatitis is independent of duodenopancreatic-duct reflux and may not be related to the presence or recent passage of common-bileduct stones.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002758:Cholangiography; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000209:etiology*; D012744:Sex Ratio