Further Data Concerning the Experimental Production of Pancreatitis*

A clinical study of chronic pancreatitis

“…The presence of uninfected bile at normal pressure in the pancreatic duct gives rise to little trouble (Rich and Duff, 1936;Mallet-Guy, Guillet, and Durand, 1948). But if there is spasm or stenosis of the sphincter of Oddi, where a common channel exists, the resultant rise in pressure, together with the presence of bile in the pancreatic duct, wiil ,produce degenerative changes in the pancreas (Archibald -and Gibbons, 1921), and these changes will be accentuated if infection is present as well (Rich and Duff, 1936). The association of chronic pancreatitis and gall bladder disease, where a common chanin exists, is therefore to be expected.…”

Harbinger or hermit? Pancreatic anatomy and surgery through the Ages—Part 3

“…It also provided an immediate area in which to focus surgical intervention. These theories were extended by Archibald in the late 1910s and early 1920s when he studied the effect of bile infiltration of the pancreas and the means by which it occurred [30]. By the time he was examining the question of etiology, three prevailing theories had been established.…”

“…Initially, in 1919, he postulated that spasm at the sphincter of Oddi allowed for biliary infiltration. Two years later he published an extensive review of his research in the area, commenting on the possible mecha-nism by which this spasm might occur [30]. His summary noted several important concepts.…”

“…Again, this would play an important role in justifying surgical intervention for both acute and chronic pancreatitis. Finally, he noted that spasm of the common duct sphincter was not only due to intestinal acidity but also, "by a sudden distention-... through abnormal and unexpected rises of pressure in the gall-bladder" [30]. Perhaps his was the primary reason cholecystectomy was advised, even after conservative management of pancreatitis became commonplace.…”