Associated Liver Disease in Alcoholic Chronic Pancreatitis

Abstract

Background: Alcohol is a common etiological factor in the pathogenesis of both pancreatic and liver disease. The frequencies of associated liver histological change in patients with alcoholic chronic pancreatitis (AICP) vary from series to series. Significant proportion of patients with alcoholic pancreatitis does have histological changes in liver. Subjects and Methods: The study was conducted at Narayana Medical College & Hospital, Chintareddy Palem, Nellore, Andhra Pradesh on liver-biopsy specimens from 23 patients with chronic alcoholic pancreatitis subjected to operation for pain, from August 2015 to July 2016 and all the patients had undergone liver biopsy at the time of surgery for AICP. The patients were followed as part of a prospective study of 33 patients who had been treated for chronic pancreatitis. The pathologists were requested to report on alcohol related histological changes in the specimen. Results: There were 23 patients and all were men. Chronic pancreatitis was   due to alcohol abuse in all patients. The median age at surgery was 39.8 years. The mean duration of alcohol abuse was 20.5 years (range 6-29 years).The average alcohol intake was 122gm 36gms/day. Three patients had jaundice for 3-6 months duration. None of the patients had any other risk factor for liver disease and none of them had clinical or biochemical evidence of liver disease. The histological reports were, 4 patients had alcoholic hepatitis, 2 severe steatohepatitis, 1 granulomatous hepatitis, 3 cholestasitc changes, one fatty liver and 12 had no significant pathology. None of the patients had cirrhosis. Thus significant alcoholic liver disease was present in 30.4% (7/23) of the patients. There was  no increased incidence of post-operative mortality and morbidity in patients with liver pathology. Conclusion: As reported in many other series, chronic alcoholic pancreatitis is associated with histological changes in liver in significant proportion of patients. However its clinical significance and prognosis of these patients are unknown.