THE RELATIONSHIP BETWEEN DRINKING STATUS AND SERIAL CHANGES OF PANCREATOGRAPHIC FINDINGS IN PATIENTS WITH SUSPECTED EARLY CHRONIC-ALCOHOLICPANCREATITIS

Twenty-two patients (mean age, 48.5 years) suspected of early chronic alcoholic pancreatitis, who had ductal changes mainly in the side bran ches, were followed by serial endoscopic retrograde pancreatography (E RP). Follow-up ranged from 1.1 to 11.9 years (mean, 5.4). Serial ERP r evealed deterioration in six patients (27%), five of whom had outflow disturbance of the main pancreatic duct. On the other hand, five patie nts presented slight progressive changes restricted to the side branch es and the remaining 11 patients showed no change. None of the 12 pati ents who abstained from drinking showed a deterioration of their pancr eatogram. The deterioration of clinical symptoms was less frequently s een in patients with abstinence (5/12) than in those who continued dri nking (10/10). This study suggests that a ductal abnormality mainly in the side branches may be an early sign of chronic alcoholic pancreati tis. Outflow disturbance of the main pancreatic duct might play an imp ortant role in the progression of the pancreatogram to an advanced sta ge, Abstinence is associated with a high probability of stabilization of both clinical symptoms and ductal changes.