Table of Contents
HPB Surgery
Volume 1, Issue 4, Pages 263-270
http://dx.doi.org/10.1155/1989/75793

Obstructive Jaundice in Chronic Pancreatitis

Department of Surgery, Westmead Hospital, Westmead, 2145 NSW, Australia

Received 24 May 1988; Accepted 6 November 1988

Copyright © 1989 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Significant obstructive jaundice in chronic pancreatitis is generally considered to be rare. Eleven of 57 consecutive patients with proven chronic pancreatitis have developed significant obstructive jaundice of more than transient duration. Eight presented as jaundice complicating known pancreatitis and three as jaundice of unknown cause.

Life table analysis showed a steady rise in the risk of developing jaundice up to the end of 10 years from the onset of chronic pancreatitis. Jaundice was found to occur in the presence of more “destructive” disease, and jaundiced patients had a higher incidence of pancreatic calcification, diabetes and malabsorption at the time of presentation with jaundice.

Obstructive jaundice caused by chronic pancreatitis was found to carry a good prognosis for jaundice, for pain and for life. Only one of the 11 patients died in hospital.

It is important to distinguish chronic pancreatitis from cancer in these patients. Pre-operative and intraoperative cytology have been helpful. Stent insertion is not an appropriate method of treatment for these patients because of the benign nature of the disease and the possibility of exacerbating the pancreatitis. It is important to be aware of another form of “malignant masquerade” causing obstructive jaundice.