Kumar Manesh, Abbas Zaigham, Gazder Darayus P, Nazir Shamim, Hyder Zeeshan, Yousuf Aasia, Bansari Shard K, Bai Kajal
Departments of Gastroenterology and Hepatology, Dr Ziauddin University Hospital, Karachi, Sindh, Pakistan.
Department of Gastroenterology, Dr Ziauddin University Hospital, Karachi, Sindh, Pakistan.
Euroasian J Hepatogastroenterol. 2025 Jan-Jun;15(1):34-37. doi: 10.5005/jp-journals-10018-1467. Epub 2025 Jun 18.
This cross-sectional study aimed to determine the frequency of distal biliary strictures in biliary pancreatitis, their relation with clinical and biochemical characteristics, and possible associations as a precipitating factor.
A total of 51 patients with biliary pancreatitis were assessed for distal common bile duct (CBD) strictures and stones. Demographic data, biochemical parameters, and imaging findings were analyzed. Comparative analyses were conducted to evaluate differences between patients with and without strictures or stones.
The mean age of the cohort was 54.0 ± 16.72 years, with females comprising 58.8% of the population. Distal CBD strictures were detected in 54.9% of patients, more frequently in females (64.3%) compared with males (35.7%). Patients without strictures accounted for 45.1%, with an almost equal gender distribution (52.2% females and 47.8% males). The CBD stones were identified in 70.6% of cases, with a marginally higher frequency among females (52.8%). Comparative analyses between patients with and without strictures showed no statistically significant differences in amylase ( = 0.616), lipase ( = 0.531), total bilirubin ( = 0.674), alanine aminotransferase ( = 0.589), aspartate aminotransferase ( = 0.621), gamma-glutamyl transferase ( = 0.483), or alkaline phosphatase ( = 0.398). Similarly, no significant differences were observed between patients with and without CBD stones in amylase ( = 0.420), lipase ( = 0.471), total bilirubin ( = 0.545), or inflammatory markers such as C-reactive protein ( = 0.313). Among patients with strictures, 53.6% had concurrent CBD stones, compared with 91.3% of those without strictures ( = 0.005).
Distal CBD strictures were present in over half of the patients with acute biliary pancreatitis (ABP). The presence of CBD stones was less common in these patients. Strictures were more common in females. There is a possibility that the presence of stricture may itself lead to complete obstruction even without stone when plugged with sludge or microlithiasis, ending up in the building of back pressure and pancreatitis.
Kumar M, Abbas Z, Gazder DP, Is there any Association of Distal Biliary Strictures with Acute Pancreatitis? Euroasian J Hepato-Gastroenterol 2025;15(1):34-37.
本横断面研究旨在确定胆源性胰腺炎中远端胆管狭窄的发生率、其与临床及生化特征的关系，以及作为诱发因素的可能关联。
共评估了51例胆源性胰腺炎患者的胆总管远端（CBD）狭窄及结石情况。分析了人口统计学数据、生化参数及影像学检查结果。进行了对比分析以评估有或无狭窄及结石患者之间的差异。
该队列患者的平均年龄为54.0±16.72岁，女性占58.8%。54.9%的患者检测到胆总管远端狭窄，女性（64.3%）比男性（35.7%）更常见。无狭窄患者占45.1%，性别分布几乎相等（女性52.2%，男性47.8%）。70.6%的病例发现有胆总管结石，女性的发生率略高（52.8%）。有或无狭窄患者之间的对比分析显示，淀粉酶（P = 0.616）、脂肪酶（P = 0.531）、总胆红素（P = 0.674）、丙氨酸氨基转移酶（P = 0.589）、天冬氨酸氨基转移酶（P = 0.621）、γ-谷氨酰转移酶（P = 0.483）或碱性磷酸酶（P = 0.398）无统计学显著差异。同样，有或无胆总管结石患者在淀粉酶（P = 0.420）、脂肪酶（P = 0.471）、总胆红素（P = 0.545）或炎症标志物如C反应蛋白（P = 0.313）方面也未观察到显著差异。在有狭窄的患者中，53.6%同时有胆总管结石，而无狭窄患者中这一比例为91.3%（P = 0.005）。
超过半数的急性胆源性胰腺炎（ABP）患者存在胆总管远端狭窄。这些患者中胆总管结石的存在不太常见。狭窄在女性中更常见。即使没有结石，当狭窄被胆泥或微结石堵塞时，也有可能导致完全梗阻，最终形成反压并引发胰腺炎。
Kumar M, Abbas Z, Gazder DP, 急性胰腺炎与远端胆管狭窄有何关联？《欧亚肝脏胃肠病学杂志》2025；15(1):34 - 37。
