Advertisement

International Journal of Pancreatology

, Volume 29, Issue 3, pp 129–131 | Cite as

Biliary complications of pancreatic necrosis

  • Adarsh ChaudharyEmail author
  • Ajay Sachdev
  • Sanjay Negi
Article

Summary

Background. Involvement of the biliary tract in pancreatic necrosis is rare. The authors are presenting six patients with this unusual complication.

Methods. Retrospective analysis of a case series.

Results. The necrotic process involved the bile duct in four patients (bile duct alone in two and bile duct with duodenum in two) and the gall bladder in two patients. It was not possible to make a preoperative diagnosis of biliary tract involvement in any of these patients. The lesions in the biliary tract were caused by the direct erosion by the necrotic tissue in five patients, and in one patient with gangrene of the gall bladder, it was a “remote” complication of the necrotizing process. All patients underwent surgery. Necrosectomy and cholecystectomy were performed in patients with gall bladder lesions, and proximal biliary drainage was the method of choice in patients with erosion of the bile duct. One patient died postoperatively. During follow-up, another patient who had bile-duct involvement developed a stricture in the damaged part of the bile duct and needed hepaticojejunostomy

Conclusions. Necrotizing pancreatitis can involve the biliary tract, both by direct extension and by its secondary effects. Although cholecystectomy is the treatment of choice in the presence of gallbladder involvement, proximal biliary diversion may be indicated in patients with erosion of the bile duct.

Key Words

Pancreatic necrosis acute pancreatitis—complications 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Miller BM, Traverso LW, Freeny PC. Intrapancreatic communication of bile and pancreatic ducts secondary to pancreatic necrosis. Arch Surg 1988;124:1000–1003.Google Scholar
  2. 2.
    Dhall JC, Marwah S, Singh RB, Marwah N, Mathur SK. Extrahepatic biliary ductal necrosis in acute pancreatitis: a rare complication. Pediatr Surg Int 2000;16:209–210.PubMedCrossRefGoogle Scholar
  3. 3.
    Schein M, Assalia A, Schmulerski P, Meislin V, Hashmonai M. Infected peripancreatic necrosis causing gall-bladder necrosis by direct extension. HPB Surgery 1993;7:77–79.PubMedCrossRefGoogle Scholar
  4. 4.
    Halliday AW, Wood CB. Gall bladder necrosis in acute pancreatitis. Br J Clin Pract 1986;40:539–540.PubMedGoogle Scholar
  5. 5.
    Cullen JJ, Maes EB, Aggarwal S, Conklin JL, Ephgrave KS, Mitros FA. Effect of endotoxin on opossum gall bladder motility: a model of acalculous cholecystitis. Ann Surg 2000;2:202–207.CrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2002

Authors and Affiliations

  1. 1.Department of G.I. SurgeryG.B. Pant HospitalNew DelhiIndia

Personalised recommendations