The challenge of therapy for pancreatitis-related common bile duct stricture.
Am J Surg
; 170(6): 543-6, 1995 Dec.
Article
em En
| MEDLINE
| ID: mdl-7491997
ABSTRACT
BACKGROUND:
Opinions regarding the appropriate clinical management of pancreatitis-related common bile duct (CBD) stricture vary considerably. PATIENTS ANDMETHODS:
Nineteen patients with chronic pancreatitis and proven stricture of their CBD were included in this study. Their mean duct diameter was 16 mm, bilirubin was 8.4 mg/dL, and alkaline phosphatase was 784 mIU/mL.RESULTS:
Five patients initially treated with endoscopic biliary stent placement are doing well at a mean follow-up of 7 months with only 1 patient requiring a biliary-enteric bypass. Four patients underwent a pancreaticoduodenectomy and the other 10 patients underwent a biliary-enteric bypass. Mean bilirubin and alkaline phosphatase at 13 months after therapy were 0.9 mg/dL and 144 mIU/mL.CONCLUSION:
An endoscopically placed biliary stent will relieve obstruction due to the stricture for several months and allow the inflammatory process to follow its natural course. In patients with long-standing permanent biliary stricture, pancreatitis limited to the head of the pancreas, duodenal obstruction, or suspected pancreatic head carcinoma, pancreaticoduodenectomy is the operation of choice. Biliary-enteric bypass in association with gastric or pancreatic bypasses should be reserved for patients with severe inflammatory changes preventing a safe pancreaticoduodenectomy.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pancreatite
/
Colestase Extra-Hepática
/
Doenças do Ducto Colédoco
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Adult
/
Aged
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am J Surg
Ano de publicação:
1995
Tipo de documento:
Article
País de afiliação:
Estados Unidos