Surgical treatment of biliary complications from calcifying chronic pancreatitis.
Obstructive jaundice in patients with chronic pancreatitis still constitutes a surgical problem deserving the attention of many specialized centers throughout the world. Out of a series of 149 patients operated upon for chronic pancreatitis, 45 (30.2%) with common duct stricture secondary to pancreatic disease have been studied in this series. Eleven patients (24.4%) had transient jaundice, eleven (24.4%) persistent cholestasis and six patients (13.3%) presented cholestasis with cholangitis. Seventeen patients (37.7%) were considered to have asymptomatic biliary tract stenosis. In 37 patients, pancreatic and biliary tract surgery were performed at the same time. There were two postoperative deaths (4.4%) and the late mortality was 9.3%. Choledochojejunostomy was preferred in the treatment of biliary stricture associated with pancreatitis. Cholecystojejunostomy provides inadequate biliary decompression and should not be used in the treatment of these patients. When a pancreatojejunostomy needs to be performed in association with biliary tract decompression, a double intestinal loop technique should be used because it is associated with less morbidity and mortality.
D000328:Adult; D000437:Alcoholism / Q000150:complications; D002114:Calcinosis / Q000150:complications*; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000601:surgery*; D002908:Chronic Disease; D003137:Common Bile Duct Diseases / Q000209:etiology / Q000601:surgery*; D004322:Drainage; D005500:Follow-Up Studies; D006801:Humans; D010195:Pancreatitis / Q000150:complications* / Q000209:etiology / Q000601:surgery