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KMID : 0371319700120070019
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Journal of the Korean Surgical Society
1970 Volume.12 No. 7 p.19 ~ p.25
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Clinical Study of pancreatitis associated with jaundice, without the primary disease in biliary tract
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金春奎/Kim, Choon Keu
車濬甲/趙範九/朴富熙/Cha, Joon Kap/Cho, Bum Koo/Park, Boo Hee
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Abstract
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The complications due to pancreatitis are very variable, particularly when it is associated with
biliary tract diseases, and in spite of the most advanced laboratory test, it is still most difficult
problem to make the differential diagnosis of the icteric patient with pancreatitis.
Thirty-eight cases of pancreatitis with jaundice, without primary diseases in biliary tract, are from
260 cases Tose who were diagnosed as pancreatitis clinically, last 12 years, from Aug. 1958 to July
1969 in Yonsei Medical Center. The following studies were performed in these patients: age and
sex incidences, past history, duration, subjective and objective findings, laboratory tests, the kind of
treatmentm, recovery period, operative findings and reviews of leteratures.
Two groups of patients are presented; Group I comprises the 8 patients with persistent obstructive
jaundice, demonstrated at laborotomy to be secondary to pancreatitis and group Ⅱ comprices the 30
cases with jaundice, treated conservatively, with good recovery in average 15 days.
This study suggested that when the presence of the primary biliary disease is not confirmed
clinically among these patients with jaundice, it is preferable to treat the patient conservatively
about two weeks with careful clinical observation. It will necessitate the exploratiry laporotomy, if
the patient do not recover from clinical state of jaundice during the period of medical therapy and
observation. In the cases that no primary disease could not be found at exploration, our studies
recommand to perform the by-pass surgery for recovery and prevention of the jaundice and pancre
eatitis, such as choledochojejunotomy or choledochoduodenostomy, or to place a long arm T-tube in
common bile duct and left for a long time (about 6 months) for complete treatment of pancreatitis.
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