Shahnawaz Ali1, Purba Haldar2, Amit Ray3, Santanu Roy4, Gaurab Bose5, Arjun Chakraborty6
BACKGROUND
Chronic pancreatitis is a chronic inflammatory disease, causing complications
related to the duodenum like duodenal obstruction or complications related to the
biliary system like cholestasis, cholangitis, secondary biliary cirrhosis and
cholangiocarcinoma. The purpose of the study was to observe the occurrence,
clinical manifestations and outcome of the complications and foster a deeper
understanding of the long-term prognosis of patients suffering from chronic
pancreatitis.
METHODS
This was a prospective observational study. After taking informed consent, total
50 patients admitted in hospital with features suggestive of chronic pancreatitis
with or without duodenal or biliary complications were selected and were followed
up throughout the course of the disease. All demographic parameters, diabetic
status, liver function test, USG findings suggestive of duodenal obstruction or
biliary abnormalities, upper GI endoscopy, computed tomography of whole
abdomen, MR cholangio pancreatography and barium meal were studied.
RESULTS
Chronic pancreatitis is more common in male and the common age of presentation
is between 45 and 54 years. 12 patients were diabetics. 42 % of the total 50
patients developed transient hyperbilirubinaemia. 5 male patients and 1 female
patient had persistent hyperbilirubinaemia and had persistently raised values of
alkaline phosphatase. 1 male and 2 female patients also suffered from
hypoproteinaemia. About 42 % of the patients of chronic pancreatitis suffered
from transient rise in conjugated bilirubin and were managed conservatively. 12
% of the patients suffered from persistently raised conjugated bilirubin, indicating
biliary obstruction. 22 % of patients developed cholangitis responding to
conservative management. 12 % of cases, 5 males and 1 female suffered from
biliary stricture, and were managed surgically with hepaticojejunostomy. No cases
of cholangiocarcinoma were detected.
CONCLUSIONS
The most common complication in patients of chronic pancreatitis is transient
biliary stasis, others being cholangitis and persistent hyperbilirubinaemia. No cases
of cholangiocarcinoma were detected.
