Characteristics of endoscopic retrograde cholangiopancreatogram in patients with primary biliary cirrhosis

The findings of cholangiopancreatograms in patients with primary biliary cirrhosis vary markedly in literature. We tried to evaluate the changes of endoscopic retrograde cholangiopancreatograms in Chinese patients with primary biliary cirrhosis.

Twenty-nine patients with primary biliary cirrhosis underwent endoscopic retrograde cholangiopancreatography over the past 8 years. Three patients with a negative antimitochondrial antibody test were excluded. Well opacified cholangiograms and pancreatograms were obtained in 24 patients. Meanwhile, 16 subjects with normal cholangiopancreatogram served as controls. The characteristics and prevalence of abnormal cholangiopancreatograms in the patients and the correlation of radiography with clinical severity of the disease were evaluated.

The maximum diameters of the common bile duct (9.7 +/- 4.0 vs. 7.6 +/- 0.9 mm, NS), right (5.0 +/- 1.6 vs. 4.4 +/- 1.2 mm, NS) and left (5.1 +/- 1.2 vs. 4.9 +/- 1.4 mm, NS) intrahepatic ducts did not show significant difference between the patients with primary biliary cirrhosis and the controls. Abnormal intrahepatic cholangiograms were obtained in 12 (50%) patients including eight with diminished arborization and focal stenosis, three with crowding and tortuous branches and one with focal stenosis alone. A hepatic hilum notch on the common hepatic duct was found in eight (33.3%) patients. The abnormalities of intrahepatic ducts did not correlate with age, sex, Pugh's scores, various liver function tests or histologically cirrhotic change. One (4.2%) patient had an abnormal pancreatogram.

Abnormal intrahepatic cholangiograms are present in half of patients with primary biliary cirrhosis, but are not related to clinical severity.