ALCOHOLIC LIVER-DISEASE IN ALCOHOLIC CHRONIC-PANCREATITIS - A PROSPECTIVE-STUDY

The prevalence and characteristics of alcoholic liver disease (ALD) in patients with alcohol-induced chronic pancreatitis (AICP) are not wel l defined. Fifty consecutive patients undergoing surgery for AICP were investigated for evidence of ALD. In addition to preoperative functio nal and imaging assessment of the liver, ah had liver biopsy during su rgery, Hepatic biopsy results, were as follows: 12 patients had normal liver and 10 minimal aspecific changes; of the remaining 28 patients, 7 had liver cirrhosis, 11 showed features of alcoholic hepatitis, 2 h ad moderate steatosis, 6 extrahepatic cholestasis, and the remaining 2 had a combination of alcoholic hepatitis and cholestasis. Of the 7 pa tients with cirrhosis, 3 had oesophageal varices and 2 of these develo ped ascites in the postoperative period; in the remaining patients wit h ALD, this disease was subclinical. Patients with ALD consumed signif icantly (p < 0.005) more alcohol than those without ALD. In patients w ith cirrhosis, the duration of alcohol consumption (mean 27.6 years, r ange 18-42 years) was significantly longer (p < 0.05) than in patients without ALD (mean 19.7 years, range 8-36 years). The association of A LD with AICP is much more common than previously believed. The fact th at AICP occurs earlier than liver cirrhosis and the fact that many pat ients stop alcohol consumption after the first attacks of pancreatic p ain may explain, at least in part, the apparent rarity with which this association has been indicated by previous studies.