Cholangiographic Features in Opium-Addicted Patients at a Tertiary Hospital in Iran

Background/Aims. Destructive and metabolic changes in hepatobiliary system have been demonstrated following opium use; however, cholangiographic features of bile ducts in opium-addicted patients with sphincter of Oddi dysfunction are not clearly determined. We described these differences and assessed the effects of opium use on postendoscopic retrograde cholangiopancreatography complications. Methodology. One hundred and nineteen patients with the diagnosis of sphinctre of Oddi dysfunction according to the Geenen-Hogan classification were studied. Eight patients were confirmed opium-addicted and others were nonaddicted. Change of serum amylase concentrations after endoscopic retrograde cholangiopancreatography and clinical diagnosis of addicted and non-addicted patients were compared. Results. Serum concentrations of liver aminotransferases and alkaline phosphatase were similar between the two groups. Serum concentration of amylase before endoscopic retrograde cholangiopancreatography was similar between them, whereas concentration of this enzyme was higher in nonaddicted ones after endoscopic retrograde cholangiopancreatography. Regarding pathologic changes in papilla, opium addiction group in comparison with control group statistically showed more tumoral features (25.0% versus 5.4%) and ulcerated changes (12.5% versus 0.0%). Conclusions. Opium use can increase probability of papilla ulcerative and tumoral changes in patients with sphinctre of Oddi dysfunction. Postendoscopic retrograde cholangiopancreatography serum amylase level may be reduced following opium addiction.