Bile duct dilation with chronic methadone use in asymptomatic patients: ERCP findings in 6 patients.

Abstract:

BACKGROUND:Bile duct dilation in patients being treated by chronic narcotic substitution with methadone has been described but has not been systematically evaluated with ERCP. Retrograde cholangiographic findings in 6 patients taking methadone who were referred for evaluation of a dilated bile duct are described. METHODS:Six patients with chronic hepatitis (5 because of hepatitis C virus, 1 hepatitis B virus) who were taking methadone were evaluated by ERCP because of biliary dilation. Data were obtained regarding surgery, abdominal pain, weight loss, excessive ingestion of alcohol, liver disease, pancreatitis, and the dose and duration of methadone treatment. OBSERVATIONS:ERCP revealed bile duct dilation without evidence of choledocholithiasis, stricture, or obstructing mass. There was one complication (postprocedure pain thought to be due to methadone withdrawal). CONCLUSIONS:Chronic methadone use can lead to bile duct dilation without evidence of other significant pathology in asymptomatic patients. EUS may be safer than ERCP for evaluation of these patients, given that a need for therapeutic biliary intervention is unlikely.

journal_name

Gastrointest Endosc

authors

Firoozi B,Choung R,Diehl DL

doi

10.1067/mge.2003.315

keywords:

subject

Has Abstract

pub_date

2003-07-01 00:00:00

pages

127-30

issue

1

eissn

0016-5107

issn

1097-6779

pii

S0016510703014718

journal_volume

58

pub_type

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