Severe cholangitis following pancreaticoduodenectomy for pseudotumoral form of lymphoplasmacytic sclerosing pancreatitis.
Cholangitis associated with lymphoplasmacytic sclerosing pancreatitis may occur simultaneously or following diagnosis of pancreatitis. The natural history following inappropriate pancreatic surgery and treatment of cholangitis in this setting are ill-defined. Three patients underwent pancreaticoduodenectomy for pseudotumoral lymphoplasmacytic sclerosing pancreatitis. Jaundice or ascending cholangitis revealed severe biliary strictures at 1, 6, and 11 months, respectively, following surgery. Treatment combining corticosteroids with or without biliary stenting was efficacious in all patients. One patient with subsequent clinical and morphological relapse responded well to reintroduction of steroids. Biliary changes appeared to be immune-related based on pathological examination and response to corticosteroids.
Marrache
Frédéric
F
Fédération Médico-Chirurgicale d'Hépato-Gastroentérologie, Service de Gatroentérologie, Hôpital Beaujon, AP-HP, Clichy, France.
Hammel
Pascal
P
O'Toole
Dermot
D
Cazals-Hatem
Dominique
D
Vullierme
Marie Pierre
MP
Sibert
Annie
A
Ponsot
Philippe
P
Maire
Frédérique
F
Hentic
Olivia
O
Sauvanet
Alain
A
Lévy
Philippe
P
Ruszniewski
Philippe
P
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002404:Catheterization / Q000379:methods; D002758:Cholangiography; D015209:Cholangitis, Sclerosing / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods; D019283:Pancreatitis, Acute Necrotizing / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones