Presence and density of common bile duct microlithiasis in acute biliary pancreatitis  

作　　者：MaciejKohut AndrzejNowak EwaNowakowska-Dutawa TomaszMarek 

机构地区：[1]Department of Gastroenterology,Central Clinical Hospital,Silesian Academy of Medicine,Katowice,Poland

出　　处：《World Journal of Gastroenterology》2002年第3期558-561,共4页世界胃肠病学杂志（英文版）

基　　金：Silesian Medical Academy scientific grants-NN-4-173-94,NN-1-161-95,NN4-200-96,NN-1-248-97

摘　　要：AIM:Common bile duct microlithiasis(CBDM)is found in majority of patients with acute biliary pancreatitis(ABP)and no CBD stones in fluoroscopy during urgent ERCP.It is unclear,however,weather CBDM is a cause or the result of the disease.This prospective study was done to investigate the presence and density of CBDM in patients with ABP,when endoscopic retrograde cholangiopancreatography(ERCP) done in different periods from the onset of the disease. METHODS:One hundred fifty one consecutive patients with ABP and no CBDS on ERCP,performed as an urgent(<24 h of admission)procedure,(101-with gallbladder stones, 50 post-cholecystectomy patients),treated during last 4 years were prospectively included to the study.The presence and density of CBDM(cholesterol monohydrate crystals-CMCs and calcium bilirubinate granules-CBGs)in bile collected directly from common bile duct during ERCP was prospectively calculated according to Juniper and Burson criteria.High density of crystals was considered,when we found >10 CMCs and/or >25 clusters of CBGs on 1 slide. RESULTS:CBD microlithiasis was present in given number of patients:on d 1-30/34(88.2%,),on d2 41/49(83.7%), on d 3-23/33(69.5%,),on d4-7-24/35(58.6%)[ P for trend =0.018 ].In patients with CBD microlithiasis the high density of crystals was observed in given number of patients:on d 1-27/30(90%),on d 2-34/41(82.9%),on d3-18/23 (78.3%),on d4-7-16/24(66.7%)[P for trend=0.039]. CONCLUSION:In patients with ABP and no CBDS on ERCP, CBD microlithiasis is observed in the majority of patients, especially during the first day of the disease.Density of CBD microlithiasis is the highest in the first day of the disease.This suggests that CBD microlithiasis can be the cause and not the result of ABP.AIM: Common bile duct microlithiasis (CBDM) is found inmajority of patients with acute biliary pancreatitis (ABP) andno CBD stones in fluoroscopy during urgent ERCP. It isunclear, however, weather CBDM is a cause or the result ofthe disease. This prospective study wss done to investigatethe presence and density of CBDM in patients with ABP, whenendoscopic retrograde cholangiopancreatography (ERCP) wasdone in different periods from the onset of the diseaseMETHODS: One hundred fifty one consecutive patients withABP and no CBDS on ERCP, performed as an urgent ( ＜ 24h of admission) procedure, (101 - with gallbladder stones,50 post-cholecystectomy patients), treated during last 4years were prospectively included to the study. Thepresence and density of CBDM (cholesterol monohydratecrystals-CMCs and calcium bilirubinate granules-CBGs) inbile collected directly from common bile duct during ERCPwas prospectively calculated according to Juniper andBurson criteria. High density of crystals was considered,whenwe found ＞ 10 CMCs and/or ＞ 25 clusters of CBGs on 1 slide.RESULTS: CBD microlithiasis was present in given numberof patients: on d 1-30/34 (88.2 %), on d2 41/49 (83.7 %),on d3-23/33 (69.6 %), on d4-7-24/35 (68.6 %) [ P for trend= 0. 018 ]. In patients with CBD microlithiasis the highdensity of crystals was observed in given number ofpetients:on d 1-27/30 (90 %), on d2-34/41 (82.9 %), on d3-18/23(78.3 %), on d 4-7-16/24 (66.7 %)[ P for trend =0.039].CONCLUSION: In patients with ABP and no CBDS on ERCP,CBD microlithiasis is observed in the majority of patients,especially during the first day of the disease. Density ofCBD microlithiasis is the highest in the first day of thedisease. This suggests that CBD microlithiasis can be thecause and not the result of ABP.

关 键 词：Acute Disease Adult Aged CHOLELITHIASIS Female GALLSTONES Humans Male Middle Aged PANCREATITIS Prospective Studies Research Support  Non-U.S. Gov't 

分 类 号：R576[医药卫生—消化系统]