What causes bile and duodenal obstruction in chronic pancreatitis?

Updated: Jul 15, 2019
  • Author: Jason L Huffman, MD; Chief Editor: BS Anand, MD  more...
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Answer

Symptomatic obstruction of the bile duct and/or duodenum develops in 5-10% of patients with chronic pancreatitis. Postprandial pain and early satiety are characteristic of duodenal obstruction, while pain and abnormal liver function test results (including hyperbilirubinemia) are suggestive of a bile duct stricture. These complications are most commonly seen in patients with dilated pancreatic ducts; they are either due to inflammation and fibrosis in the head of the pancreas or are the result of a pseudocyst.

Drainage of an obstructing pseudocyst can be accomplished surgically by cystogastrostomy, cystenterostomy, or choledochoenterostomy. Endoscopic stenting may be helpful for benign bile duct strictures.


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