[The diagnosis and treatment for chronic pancreatitis complicated by non-calculous obstructive jaundice].
OBJECTIVE
To study the characters of chronic pancreatitis complicated by non-calculous obstructive jaundice, and discuss the methods for differentiation and treatment.


METHODS
Twenty cases selected from January 1985 to December 2004 were analysed in the fields of differentiation and treatment.


RESULTS
All cases didn't present with typical clinical presentations and radiological features. Jaundice was presented as the main complaint. Stricture of the intra-pancreatic common bile duct was the symbolic radiological feature. Pancreatic disseminated inflammation was verified pathologically in these cases. CT, ultrasound, EUS, ERCP, MRCP and antigen-marker of neoplasm failed to offer the data for differentiation. The diagnosis could only be determined by pathological exam. The obstructive jaundice could be solved by biliary-enteric anastomoses successfully.


CONCLUSIONS
The patients with sole complaint of obstructive jaundice account for 15% of all inpatients with chronic pancreatitis. There exists a direct relationship between the jaundice and the pancreatic inflammation. This disorder should be differentiated from total pancreatic carcinoma, but few differentiated material could be offered by preoperative studies. Pathological result derived from the tissue sample obtained within the exploration would be reliable for diagnosis. The bypass between biliary tract and intestine would be a safe and economical treatment method.
Zhuang
Yan
Y
Department of Surgery, First Hospital, Peking University, Beijing 100034, China. h44368@sina.com
Yang
Yin-mo
YM
Wang
Wei-min
WM
Wang
Hui-yuan
HY
Wan
Yuan-lian
YL
Huang
Yan-ting
YT
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001707:Biopsy, Needle; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002768:Choledochostomy / Q000379:methods*; D002908:Chronic Disease; D019160:Endosonography; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed