[Hepatobiliary and pancreatic complications in patients with ulcerative colitis]

Twenty-four cases of primary sclerosing cholangitis (PSC) and 17 cases of acute or chronic pancreatitis associated with ulcerative colitis (UC) reported in Japan were reviewed. Most of PSC cases revealed intra- and extra-hepatic bile duct involvement. Symptoms of the 22 cases disappeared by predonisolone (PSL) and/or salazosulfapyridine (SASP). Ursodeoxycholic acid was effective in 4 patients. One case received liver transplantation, but currently his liver is biliary cirrhotic 11 years after operation. Another case received total colectomy and pyoderma gangrenosum was cured. Twelve cases had acute pancreatitis, and 5; chronic. Pancreatic duct of 9 patients on ERCP was stenotic and dilated; pancreas was swelling in 3; and normal, in 2. SASP and/or PSL for UC and pancreatitis in 16 patients were effective. Gabexate mesilate and/or urinastatin was used in 10 patients. Only one patient with jaundice received pancreatoduodenectomy. When UC is well controlled, PSC and pancreatitis may be remitted.