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Richard A. Prinz, MD; Gerard V. Aranha, MD; Herbert B. Greenlee, MD

Arch Surg. 1985;120(3):361-366.

Abstract
• In 55 patients undergoing pancreaticojejunostomy for intractable abdominal pain, common bile duct obstruction occurred in 29% (16/55) and duodenal obstruction occurred in 15% (8/55). Serum alkaline phosphatase and total and direct serum bilirubin levels were significantly higher in patients with intrapancreatic common bile duct stenosis. Transient upper gastrointestinal (UGI) tract obstruction was common with chronic pancreatitis; however, if symptoms persisted beyond 2 weeks, fixed duodenal obstruction was likely. Endoscopic retrograde cholangiopancreatography and UGI roentgenograms and endoscopy were useful in confirming mechanical obstruction to the biliary and UGI tracts, respectively. There was no difference in operative mortality and morbidity from combined drainage procedures compared with pancreaticojejunostomy alone. The biliary and UGI tracts should be investigated in symptomatic patients both before and after pancreaticojejunostomy. Combined drainage of the pancreatic duct and UGI and biliary tract is safe and effective treatment for obstructing complications of chronic pancreatitis.

(Arch Surg 1985;120:361-366)

Author Affiliations
From the Department of Surgery, Loyola University Medical Center, and the Surgical Service, Hines Veterans Administration Hospital, Maywood, Ill.

Footnotes
Accepted for publication Aug 29, 1984.

Read before the Eighth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Los Angeles, May 12, 1984.

Reprint requests to Department of Surgery, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153 (Dr Prinz).

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