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이동기,장우익,권상옥,노병선 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2
Intrapancreatic biliary stricture have been estimated to occurs in 5.7% of patients with chronic alcoholic pancreatitis. The stricture is due to encasement of the intraor peripancreatic bile duct in a progressively fibrotic pancreas, with edema and inflammation of an acute pancreatic episode often exacerbating the stricture. Opinions regarding the clinical significance and appropriate treatment for these lesions are variable. We report 4 cases with intrapancreatic bile duct stricture secondary to chronic alcoholic pan-creatitis. The strictures were identified by Endoscopic retrograde cholangiopancreatography (ERCP, 3 cases) and Percutaneous transhepatic cholangiography (PTC, 1 case). The mean stricture length was 4.2±1.23 ㎝, and the mean common bile duct diameter was 1.7±0.19 ㎝. Two patients had pancreatic pseudocyst. Two patients received operation for biliary decompression and evaluation of focal inflammatory pancreas mass respectively. One patient treated conservatively. One patient was lost for follow up. In two liver biopsy specimens, no feature of biliary cirrhosis was found. All three treated patient doing well for 10 to 22 months respectively after treatment with abstinence from alcohol.