title: Severe cholangitis following pancreaticoduodenectomy for pseudotumoral form of lymphoplasmacytic sclerosing pancreatitis.
abstract: 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.
authors.affiliation: Fédération Médico-Chirurgicale d'Hépato-Gastroentérologie, Service de Gatroentérologie, Hôpital Beaujon, AP-HP, Clichy, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Marrache
authors.forename: Pascal
authors.initials: P
authors.lastname: Hammel
authors.forename: Dermot
authors.initials: D
authors.lastname: O'Toole
authors.forename: Dominique
authors.initials: D
authors.lastname: Cazals-Hatem
authors.forename: Marie Pierre
authors.initials: MP
authors.lastname: Vullierme
authors.forename: Annie
authors.initials: A
authors.lastname: Sibert
authors.forename: Philippe
authors.initials: P
authors.lastname: Ponsot
authors.forename: Frédérique
authors.initials: F
authors.lastname: Maire
authors.forename: Olivia
authors.initials: O
authors.lastname: Hentic
authors.forename: Alain
authors.initials: A
authors.lastname: Sauvanet
authors.forename: Philippe
authors.initials: P
authors.lastname: Lévy
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruszniewski
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones