Henry Ford Hospital Medical Journal


Persistent obstructive jaundice due to stenosis of the distal common bile duct by chronic pancreatitis has been documented in 13 patients of 253 for whom the diagnosis of chronic pancreatitis has been established. All 13 cases required operation; obstructive jaundice was present at surgery in nine; four had recurring jaundice for prolonged periods. None had associated biliary lithiasis. All cases showed evidence of excess alcohol intake. The jaundice, often associated with mild to moderate pain, was disabling and life-endangering and was relieved by operation. In these patients carcinoma must always be ruled out by diagnostic studies, operation, and the elapse of time. Choledochoenterostomy is considered the operative procedure of choice. Other complications of chronic pancreatitis which may also require operative procedures include pancreatic duct obstruction with disabling pain (three patients), pseudocyst formation (one patient), and duodenal obstruction (one patient).