Which of the following statement(s) concerning bile duct strictures due to chronic pancreatitis is/are true?

b.Strictures are classically long and tapered involving the entire intrapancreatic bile duct

c.Patients may be asymptomatic and diagnosed only by persistent elevation of serum alkaline phosphatase

d.An excellent option for surgical management is choledochoduodenostomy

The clinical presentation of patients with common bile duct strictures secondary to chronic pancreatitis is variable. A large number of patients are asymptomatic with a diagnosis of bile duct strictures suggested only by abnormal liver function tests. The serum alkaline phosphatase appears to be the most sensitive laboratory finding and is elevated in over 80% of patients. Although in most cases, transient jaundice may occur, progressive jaundice is rare. Cholangiography will demonstrate a classic long smooth gradual tapering of the common bile duct throughout its entire intrapancreatic segment. Biliary reconstruction is the appropriate management for most patients. Choledochoduodenostomy is preferred by many surgeons because it does not divert bile from the duodenum, is technically easier to perform, and leaves the jejunum intact for any associated procedures that may be required for decompression of the obstructed gastrointestinal tract or pancreatic duct.