Is pancreatic duct obstruction or stricture a major cause of pain in calcific pancreatitis?

Forty-seven patients with calcific pancreatitis were submitted to ERCP, 24 of whom were designated 'painless' and 23 'painful', according to whether or not pain had occurred during the previous year. The pancreatic duct was cannulated in 39 of these patients. The incidence of pancreatic duct obstruction or stricture was of the same order in the painless (13/20, 65 per cent) and painful (15/19, 79 per cent) groups. Alcohol was the aetiological factor in 46 patients. Twenty-four (52 per cent) continued to drink, and were equally divided between the painless (12) and painful (12) groups. Four out of 13 in the painless and 7 out of 14 in the painful groups, with a stricture or obstruction, continued to drink. The difference was statistically not significant. These results suggest that ERCP findings of pancreatic duct obstruction or stricture need not necessarily be pertinent to the pain in patients with chronic pancreatitis.