INTRODUCTION: Biliary obstruction in chronic calcific pancreatitis (CCP) is often caused by inflammatory or fibrotic strictures of the bile duct, carcinoma of head of pancreas or less commonly by compression from pseudocysts. Pancreatic calculi causing ampullary obstruction and leading to obstructive jaundice is extremely rare. METHODS: The medical records of all patients with CCP or biliary obstruction who underwent endoscopic retrograde cholangiopancreatography (ERCP) over 4 years between 2010-2014 at Kasturba Medical College, Manipal were analyzed. RESULTS: Five patients of CCP with impacted pancreatic calculi at the ampulla demonstrated during ERCP were identified. All 5 presented with biliary obstruction and were incidentally detected to have CCP when evaluated for the same; 3 patients had features of cholangitis. All the patients were managed successfully by endoscopic papillotomy and extraction of pancreatic calculi from the ampulla with resolution of biliary obstruction. CONCLUSION: Pancreatic calculus causing ampullary obstruction, though very rare, should be considered as a possibility in patients with CCP complicated by biliary obstruction. Endoscopic therapy is affective in the resolution of biliary obstruction in such patients.
INTRODUCTION:Biliary obstruction in chronic calcific pancreatitis (CCP) is often caused by inflammatory or fibrotic strictures of the bile duct, carcinoma of head of pancreas or less commonly by compression from pseudocysts. Pancreatic calculi causing ampullary obstruction and leading to obstructive jaundice is extremely rare. METHODS: The medical records of all patients with CCP or biliary obstruction who underwent endoscopic retrograde cholangiopancreatography (ERCP) over 4 years between 2010-2014 at Kasturba Medical College, Manipal were analyzed. RESULTS: Five patients of CCP with impacted pancreatic calculi at the ampulla demonstrated during ERCP were identified. All 5 presented with biliary obstruction and were incidentally detected to have CCP when evaluated for the same; 3 patients had features of cholangitis. All the patients were managed successfully by endoscopic papillotomy and extraction of pancreatic calculi from the ampulla with resolution of biliary obstruction. CONCLUSION:Pancreatic calculus causing ampullary obstruction, though very rare, should be considered as a possibility in patients with CCP complicated by biliary obstruction. Endoscopic therapy is affective in the resolution of biliary obstruction in such patients.
Authors: J-M Dumonceau; A Tringali; D Blero; J Devière; R Laugiers; D Heresbach; G Costamagna Journal: Endoscopy Date: 2012-02-01 Impact factor: 10.093
Authors: Jacques Devière; D Nageshwar Reddy; Andreas Püspök; Thierry Ponchon; Marco J Bruno; Michael J Bourke; Horst Neuhaus; André Roy; Ferrán González-Huix Lladó; Alan N Barkun; Paul P Kortan; Claudio Navarrete; Joyce Peetermans; Daniel Blero; Sundeep Lakhtakia; Werner Dolak; Vincent Lepilliez; Jan W Poley; Andrea Tringali; Guido Costamagna Journal: Gastroenterology Date: 2014-05-04 Impact factor: 22.682
Authors: S Chari; V Jayanthi; V Mohan; S Malathi; N Madanagopalan; M Viswanathan Journal: J Gastroenterol Hepatol Date: 1992 Jan-Feb Impact factor: 4.029