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Pancreatic duct stones: A report on 16 cases.
Adv Clin Exp Med. 2017 Jul; 26(4):609-613.AC

Abstract

BACKGROUND

Pancreatolithiasis occurs in less than 1% of the general population and is mainly recognized in patients with chronic pancreatitis. Selection of the appropriate treatment method depends on the location, size and number of stones.

OBJECTIVES

The aim of the study was to analyze data concerning patients with pancreatic duct stones who were hospitalized at Wroclaw Medical University's Department of Gastroenterology and Hepatology from 2010 to 2014.

MATERIAL AND METHODS

The study presents data on 16 patients with pancreatic duct stones, who constituted 7% of all 228 patients with chronic pancreatitis hospitalized at the Department in the study period. The clinical data were compared with findings reported in the literature.

RESULTS

Epigastric pain was the most common symptom reported by patients with pancreatolithiasis. The sensitivity of imaging tests in the diagnosis of pancreatic duct stones was as follows: abdominal ultrasonography - 31%, endoscopic retrograde cholangiopancreatography (ERCP) - 67%, computed tomography - 71%, endoscopic ultrasonography - 73%. In 6 patients ERCP and sphincterotomy were performed along with stenting of the main pancreatic duct. Three other subjects were qualified for surgical treatment. In 7 selected patients conservative treatment and further observation were applied.

CONCLUSIONS

Endoscopic ultrasonography is characterized by high sensitivity in the diagnosis of pancreatic duct stones. ERCP is the first-line treatment in the case of a small number of stones with sizes below 5 mm located in the head or body of the pancreas. In the case of stones with sizes ≥ 5 mm, extracorporeal shock wave lithotripsy should be performed before endoscopic drainage during ERCP. Stenosis of the main pancreatic duct is the key risk factor for the recurrence of pancreatolithiasis.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland.Department of Minimally Invasive Surgery and Proctology, Wroclaw Medical University, Poland.Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland.Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland.Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28691427

Citation

Panek-Jeziorna, Magdalena, et al. "Pancreatic Duct Stones: a Report On 16 Cases." Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University, vol. 26, no. 4, 2017, pp. 609-613.
Panek-Jeziorna M, Wierzbicki J, Annabhani A, et al. Pancreatic duct stones: A report on 16 cases. Adv Clin Exp Med. 2017;26(4):609-613.
Panek-Jeziorna, M., Wierzbicki, J., Annabhani, A., Paradowski, L., & Mulak, A. (2017). Pancreatic duct stones: A report on 16 cases. Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University, 26(4), 609-613. https://doi.org/10.17219/acem/62687
Panek-Jeziorna M, et al. Pancreatic Duct Stones: a Report On 16 Cases. Adv Clin Exp Med. 2017;26(4):609-613. PubMed PMID: 28691427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreatic duct stones: A report on 16 cases. AU - Panek-Jeziorna,Magdalena, AU - Wierzbicki,Jarosław, AU - Annabhani,Abdulhabib, AU - Paradowski,Leszek, AU - Mulak,Agata, PY - 2017/7/12/pubmed PY - 2018/2/21/medline PY - 2017/7/11/entrez KW - chronic pancreatitis KW - endoscopic retrograde cholangiopancreatography KW - pancreatic duct stone KW - pancreatolithiasis SP - 609 EP - 613 JF - Advances in clinical and experimental medicine : official organ Wroclaw Medical University JO - Adv Clin Exp Med VL - 26 IS - 4 N2 - BACKGROUND: Pancreatolithiasis occurs in less than 1% of the general population and is mainly recognized in patients with chronic pancreatitis. Selection of the appropriate treatment method depends on the location, size and number of stones. OBJECTIVES: The aim of the study was to analyze data concerning patients with pancreatic duct stones who were hospitalized at Wroclaw Medical University's Department of Gastroenterology and Hepatology from 2010 to 2014. MATERIAL AND METHODS: The study presents data on 16 patients with pancreatic duct stones, who constituted 7% of all 228 patients with chronic pancreatitis hospitalized at the Department in the study period. The clinical data were compared with findings reported in the literature. RESULTS: Epigastric pain was the most common symptom reported by patients with pancreatolithiasis. The sensitivity of imaging tests in the diagnosis of pancreatic duct stones was as follows: abdominal ultrasonography - 31%, endoscopic retrograde cholangiopancreatography (ERCP) - 67%, computed tomography - 71%, endoscopic ultrasonography - 73%. In 6 patients ERCP and sphincterotomy were performed along with stenting of the main pancreatic duct. Three other subjects were qualified for surgical treatment. In 7 selected patients conservative treatment and further observation were applied. CONCLUSIONS: Endoscopic ultrasonography is characterized by high sensitivity in the diagnosis of pancreatic duct stones. ERCP is the first-line treatment in the case of a small number of stones with sizes below 5 mm located in the head or body of the pancreas. In the case of stones with sizes ≥ 5 mm, extracorporeal shock wave lithotripsy should be performed before endoscopic drainage during ERCP. Stenosis of the main pancreatic duct is the key risk factor for the recurrence of pancreatolithiasis. SN - 1899-5276 UR - https://www.unboundmedicine.com/medline/citation/28691427/Pancreatic_duct_stones:_A_report_on_16_cases_ L2 - http://www.advances.am.wroc.pl/pdf/2017/26/4/609.pdf DB - PRIME DP - Unbound Medicine ER -