Pancreatic duct stones – a report of 16 cases

Panek-Jeziorna, Magdalena; Wierzbicki, Jarosław; Annabhani, Abdulhabib; Paradowski, Leszek; Mulak, Agata

doi:10.17219/acem/62687

Cited by 6 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the same time, most scholars believe that although there are many factors affecting pancreatic fistula, including the preoperative nutritional status, pancreatic texture, and surgical experience of the surgeon, the MPD diameter is undoubtedly one of the most important factors [22]. The more obvious the degree of pancreatic duct dilatation is, the lower the risk of postoperative complications, especially pancreatic fistula, will be, which is an important reason for drainage or combined surgery requiring pancreatic duct expansion [22,23]. The results of this study showed that the incidence of pancreatic fistula was significantly decreased when the diameter of the pancreatic duct was greater than 7 mm or 8 mm, suggesting that 7 mm and 8 mm were the standard.…”

Section: Discussionmentioning

confidence: 99%

Drainage procedure for pancreatolithiasis: re-examination of the pancreatic duct diameter standard

et al. 2020

View full text Add to dashboard Cite

Pancreatic duct decompression relieves pancreatic duct stone (PDS)-associated abdominal pain, though a consensus indication for the drainage procedure of the main pancreatic duct (MPD) is lacking. Moreover, major prognostic factors for postsurgical long-term pain relief and recurrence are largely unknown. Methods: The clinical outcomes of 65 consecutive PDS patients undergoing surgery from 2008-2012 with 3+ years of follow-up were assessed. Results: At postsurgical follow-up (median, 4.5 years; range, 3-7 years; procedure: Partington, n = 32; Frey, n = 27; pancreatoduodenectomy, n = 3; distal pancreatectomy, n = 3), the early complication and complete stone clearance rates were 29.2% and 97%, respectively. Long-term, complete and partial pain relief were 93.9%, 83.1%, and 10.8%, respectively. The risk of pancreatic fistula was higher in the <8 mm group than in the >8 mm group (P < 0.05), and 80% of the pancreatic fistula cases occurred in the <8 mm group. A shorter pain duration (P = 0.007), smaller MPD diameter (P = 0.04), and lower Izbicki pain score (P < 0.001) predicted long-term pain relief. Pain recurrence after initial remission occurred in 5 patients and was only related to pain duration (P = 0.02). Stone recurrence and pancreatic exocrine functional and endocrine functional deterioration occurred in 2, 5, and 11 patients, respectively. Conclusion: Surgery provides excellent stone clearance, long-term pain relief, and acceptable postoperative morbidity. Using 8 mm as the criterion for drainage surgery can minimize the postoperative pancreatic fistula risk. Individualized and timely surgical treatment may improve the effect of surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Drainage procedure for pancreatolithiasis: re-examination of the pancreatic duct diameter standard

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Depending upon the stones’ type and number, they can be considered radio-opaque, radiolucent, or mixed, and also as single or multiple [ 2 , 3 ]. Importantly, there is a strong association with chronic pancreatitis (CP), which is present in 50–90% of these patients [ 4 ]. However, CP in the long term can be associated with a variety of complications affecting both the pancreas (pancreatic pseudocyst, pancreatitis and pancreatic adenocarcinoma) and the adjacent anatomical structures, causing biliary and duodenal obstruction [ 3 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Pancreatolithiasis: Does Management Depend on Clinical Manifestations?

Paramythiotis,

Karlafti,

Kollatou

et al. 2024

Am J Case Rep

View full text Add to dashboard Cite

Case series Patients: Male, 78-year-old • Female, 27-year-old Final Diagnosis: Pancreatic duct stones Symptoms: Abdominal pain Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Pancreatic calculi (PC) or pancreatolithiasis refers to the presence of stones in the main pancreatic duct (MPD), side branches, or parenchyma of the pancreas. It is highly associated with chronic pancreatitis (CP), and is present in 50-90% of those patients. The stone formation can be attributed to a diversity of factors, all of them leading to obstruction in the duct, hypertension of its distal part, increased intraductal and parenchymal pressure, and inflammation, causing the standard symptom, epigastric pain. Immediate restoration of pancreatic secretion flow is of utmost importance and can be achieved with both endoscopic and surgical techniques. Endoscopic techniques include endoscopic retrograde cholangiopancreatography (ERCP) combined, if possible, with extracorporeal shock wave lithotripsy (ESWL), while surgical techniques consist of drainage and resection procedures. The choice of treatment for PC depends on the location, size, and number of stones, and the existence of other complications. Case Reports: We present 2 cases that were diagnosed with PC, in which clinical symptoms, laboratory results, and imaging examinations were different, suggesting the variety of manifestations pancreatolithiasis can cause. Each patient was treated differently, according to their clinical situation and the presence or absence of complications. Both patients were discharged and fully recovered. Conclusions: The management of pancreatolithiasis can be demanding in some cases, mostly when there are complications. The purpose of this case report is to indicate the importance of personalized treatment for each patient, as different approaches to the same medical condition should be easily identified and successfully treated.

show abstract

“…Initial treatment for uncomplicated cases is usually conservative, and includes alcohol and smoking cessation, the use of supplements including pancreatic enzymes, proton pump inhibitors, and symptomatic treatment. Surgical and interventional procedures are reserved for the cases with CP resistant to conservative treatment and complications, which are quite common (increased intrapancreatic pressure, pseudocysts, fistulas or abscesses, stenosis of the duodenum and bile duct, calculus, vascular disorders and neoplasms) [5][6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Quality of life assessment in patients treated due to chronic pancreatitis

et al. 2022

View full text Add to dashboard Cite

Introduction. Chronic pancreatitis (CP) causes inflammatory changes in the tissue of the pancreas, resulting in irreversible tissue damage. Pain, endocrine, and exocrine pancreatic insufficiency develop, thereby reducing the quality of life of patients. The study aims to explore the role of surgical treatment in improving the quality of life of patients with CP. Methods. Quality of life assessment of 50 patients diagnosed with CP was performed using a certified Euro Quality of life-5 dimension-5 level questionnaire translated into Serbian (EuroQol-5D-5L). Patients completed the questionnaire. Patients were divided into two groups (conservative - CT vs. surgical - ST), and all comparations was made between groups. Results. Patients in stage B chronic pancreatitis were divided into two groups of 25 patients. The first group of patients with CP was treated with conservative, and the second group with surgical approach. Mane age in surgically treated (ST) group was 48.56 ? 11.91, and in conservatively treated (CT) group was 51.08 ? 11.61 (p=0.452). Male/female ratio in ST group was 18/7, and in CT group was 22/3 (p=0.289). Pain in ST group was present in 23 patients, and in CT group was present in 18 patients (p=0.141). Loss of appetite in ST group was present in 7 patients, and in CT group was present in 10 patients (p=0.256). Weight loss in both groups was equal (p=1.000). Based on EuroQol-5D-5L it was found significant differences (p<0.001) between group in Mobility and Pain / Discomfort; in Anxiety / Depression (p=0.003); in Self-care (p=0.004); in Usual activities (p=0.008). Conclusion. CP significantly reduce the quality of life (QoL) of patients treated conservatively or by surgical approach. This study showed that surgical treatment is more beneficial in QoL in patients with CP then conservative approach

show abstract

Pancreatic duct stones – a report of 16 cases

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.

Cited by 6 publications

References 13 publications

Drainage procedure for pancreatolithiasis: re-examination of the pancreatic duct diameter standard

Drainage procedure for pancreatolithiasis: re-examination of the pancreatic duct diameter standard

Pancreatolithiasis: Does Management Depend on Clinical Manifestations?

Quality of life assessment in patients treated due to chronic pancreatitis

Contact Info

Product

Resources

About