Histological alterations of the preampullary common bile and pancreatic duct in acute biliary and nonbiliary pancreatitis.

Abstract

Histological alterations of the preampullary common bile duct and the pancreatic duct were studied in the pancreata from 16 patients with acute biliary pancreatitis and 11 patients with acute nonbiliary pancreatitis. The corresponding controls either suffered from gallstone disease without pancreatitis or had neither gallstone disease nor pancreatitis. In acute biliary pancreatitis as well as in gallstone disease, a common channel is significantly less frequent than in acute nonbiliary pancreatitis and in the normal pancreas. The inflammatory alterations of the preampullary common bile duct are increased in biliary pancreatitis compared to nonbiliary pancreatitis and to controls. The inflammatory lesions of the distal common bile duct and distal pancreatic duct are significantly correlated. These findings favor the assumption that acute biliary pancreatitis is initiated by transient obstruction of the preampullary common bile duct producing a local inflammation which encroaches upon the adjacent region of the pancreatic duct.