STATE OF PANCREATOBILIARY DUCTS IN PATIENTS WITH CHRONIC PANCREATITIS

Objective. To study the state of pancreatobiliary ducts in patients with various clinical and morphological forms of Chronic Pancreatitis (CP). Material and methods. Endoscopic retrograde cholangiopancreatography (ERCP} was performed in 96 patients with CP (I group - 12 patients with obstructive CP, II - 26 calcifying, III - 34 fibrous parenchymal form, IV - 24 with CP, complicated by pseudocyst). Results. For 56.6% of patients with CP, severe structural changes of the pancreas are characteristic. In the majority of patients of groups I, II and IV, severe structural changes of the pancreas were found (75.0%, 85.7% and 59.1%, respectively). In group III patients, the average (53.1%) degree of structural changes in the pancreas prevailed. Expansion and irregularity of the lumen of the main pancreatic duct (65.1%) and changes in its contour (45.8%), the presence calcifications of parenchyma (13.6%) and of main pancreatic duct (8.4% of patients) are characteristic of patients with CP. The narrowing of the main pancreatic duct in the head area was found in 9.6% of patients (more often due to compression of the pseudocyst). In 16.9% of patients, ERCP revealed a connection between the pseudocyst cavity and the pancreatic duct, which was crucial for determining further treatment tactics. For duct decompression with ductal hypertension, an endoscopic papillosphincterotomy was performed in 10.9% of patients. Conclusion. For patients with CP obstructive, calcificatory and complicated by the presence of pseudocysts is characterized by severe structural changes of the pancreas, detected by ERCP.

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