Warshaw A L, Schapiro R H, Ferrucci J T, Galdabini J J
Gastroenterology. 1976 Apr;70(4):562-7.
Long strictures of the intrapancreatic portion of the common bile duct were found in 6 patients with chronic pancreatitis. These strictures were responsible for painless obstructive jaundice, recurrent cholangitis, secondary biliary cirrhosis, and chronic abdominal pain difficult to distinguish from that caused by pancreatitis. Endoscopic retrograde cholangiopancreatography and intraoperative cholangiography were invaluable in making the diagnosis and in planning surgical correction. Decompression of the biliary tree by anastomosis of the gallbladder or common duct to the small intestine completely relieved symptoms and allowed liver function to improve significantly. Common duct stricture as a complication of chronic pancreatitis should be considered in the differential diagnosis of extrahepatic biliary obstruction and whenever surgical treatment of chronic pancreatitis is contemplated.
在6例慢性胰腺炎患者中发现胆总管胰腺内段有长段狭窄。这些狭窄导致无痛性梗阻性黄疸、复发性胆管炎、继发性胆汁性肝硬化以及难以与胰腺炎所致腹痛相鉴别的慢性腹痛。内镜逆行胰胆管造影术和术中胆管造影术对诊断及规划手术矫正极为重要。通过将胆囊或胆总管与小肠吻合来减压胆管树可完全缓解症状，并使肝功能显著改善。在肝外胆管梗阻的鉴别诊断中以及每当考虑对慢性胰腺炎进行手术治疗时，都应考虑将胆总管狭窄作为慢性胰腺炎的并发症。
