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Is there any Association of Distal Biliary Strictures with Acute Pancreatitis?
Manesh Kumar1, Zaigham Abbas2, Darayus P Gazder1
1Departments of Gastroenterology and Hepatology, Dr Ziauddin University Hospital, Karachi, Sindh, Pakistan.
Background And Objective:
This cross-sectional study aimed to determine the frequency of distal biliary strictures in biliary pancreatitis, their relation with clinical and biochemical characteristics, and possible associations as a precipitating factor.
Materials And Methods:
A total of 51 patients with biliary pancreatitis were assessed for distal common bile duct (CBD) strictures and stones. Demographic data, biochemical parameters, and imaging findings were analyzed. Comparative analyses were conducted to evaluate differences between patients with and without strictures or stones.
Results:
The mean age of the cohort was 54.0 ± 16.72 years, with females comprising 58.8% of the population. Distal CBD strictures were detected in 54.9% of patients, more frequently in females (64.3%) compared with males (35.7%). Patients without strictures accounted for 45.1%, with an almost equal gender distribution (52.2% females and 47.8% males). The CBD stones were identified in 70.6% of cases, with a marginally higher frequency among females (52.8%). Comparative analyses between patients with and without strictures showed no statistically significant differences in amylase (p = 0.616), lipase (p = 0.531), total bilirubin (p = 0.674), alanine aminotransferase (p = 0.589), aspartate aminotransferase (p = 0.621), gamma-glutamyl transferase (p = 0.483), or alkaline phosphatase (p = 0.398). Similarly, no significant differences were observed between patients with and without CBD stones in amylase (p = 0.420), lipase (p = 0.471), total bilirubin (p = 0.545), or inflammatory markers such as C-reactive protein (p = 0.313). Among patients with strictures, 53.6% had concurrent CBD stones, compared with 91.3% of those without strictures (p = 0.005).
Conclusion:
Distal CBD strictures were present in over half of the patients with acute biliary pancreatitis (ABP). The presence of CBD stones was less common in these patients. Strictures were more common in females. There is a possibility that the presence of stricture may itself lead to complete obstruction even without stone when plugged with sludge or microlithiasis, ending up in the building of back pressure and pancreatitis.
How To Cite This Article:
Kumar M, Abbas Z, Gazder DP, et al. Is there any Association of Distal Biliary Strictures with Acute Pancreatitis? Euroasian J Hepato-Gastroenterol 2025;15(1):34-37.
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