Vanishing Pancreatic Calcification in Chronic Pancreatitis

Tucker, Donald H.; Moore, Irwin

doi:10.1056/nejm196301032680107

Cited by 41 publications

(6 citation statements)

References 6 publications

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“…The profound decrease in pancreatic stones solubility induced by HC03 concentrations and pH occurring in pancreatic ducts, is a major factor in explaining why pancreatic stones once formed do not, or quite seldom do, spon taneously dissolve (12,13). After gaining this information it was necessary to study the ef fects of a molecule with a large affinity for calcium, in order to test in vitro, then thera peutic, dissolution.…”

Section: Discussionmentioning

confidence: 99%

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Studies on Pancreatic Stones

1981

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To determine the solubility of pancreatic stones, in vitro experiments were performed by using the anaerobic percolation method. During steady-state conditions an inverse relationship between size and solubility in 150 mM NaCl was observed. The effects of several solvents on pancreatic stones solubility were studied: albumin induced a concentration-dependent increase, while bicarbonate induced a concentration-dependent decrease. Citrate dramatically increased the solubility of pancreatic stones, an increase which was not antagonized by adding bicarbonate. Total in vitro dissolution of 50 mg pancreatic stones was attempted by percolating 150 mM NaCl or 3.9 mM citrate, a concentration which can be reached in pancreatic juice during intraduodenal infusion of citrate. Extrapolated time of total dissolution was 60 days with NaCl percolation, while actual time with citrate percolation was 25 days. The potential usefulness of citrate treatment of chronic calcified pancreatitis is discussed.

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Section: Discussionmentioning

confidence: 99%

“…Until now no attempt has been made to increase the solubility of human pancreatic stones and no publication has reported their in vitro dissolution, although in some instances, their spontaneous disappearance in the course of chronic calcified pancreatitis has been re ported (12,13).…”

Section: Introductionmentioning

confidence: 99%

Studies on Pancreatic Stones

1981

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“…An additional patient had a carcinoma of the tongue cured by radiotherapy. On the other hand, we found no carcinoma of the pancreas, which is considered to be more frequent in chronic pancreatitis [7,12,23,29],…”

Section: B) Pancreatic Function Studiesmentioning

confidence: 99%

Chronic Pancreatitis in Zurich, 1963–1972

Ammann¹,

Hammer²,

Fumagalli³

1973

Digestion

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Within the last 10 years, 102 cases of chronic pancreatitis have been observed, indicating that the incidence of chronic pancreatitis in Zurich is much higher than previously claimed. 84% of our patients are male with an average age of 43 years at onset. Pancreatic calcifications were demonstrated in 63%. Chronic alcoholism occurs in 62% of all patients. In our experience, ‘acute pancreatitis’ in chronic alcoholics is almost always the first manifestation of chronic relapsing pancreatitis, which is detected on the average 5 years after the first pain episode. Pancreatic exocrine insufficiency demonstrated by the CCK-secretin test was found in 99% of the patients tested, steatorrhea in 72%, and clinical or subclinical diabetes in 83%. 29 of the 102 patients died during the average follow-up time of 8.6 years. Death was due to complications of pancreatitis in about 30%. 35% of all patients were operated on for complications or for severe pain. But 36% of patients with chronic relapsing pancreatitis became painless spontaneously (‘secondary painless’ pancreatitis) after an average period of 6.6 years. In patients with ‘secondary painless’ pancreatitis, severe pancreatic insufficiency is predominantly present, indicating that chronic pancreatitis has the tendency to ‘burn out’ spontaneously.

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“…Since 1963 several classifications of CP have been introduced [ 3 – 7 ]. These classifications were mainly concerned with the distinction between acute pancreatitis and CP.…”

Section: Introductionmentioning

confidence: 99%

The different course of alcoholic and idiopathic chronic pancreatitis: A long-term study of 2,037 patients

et al. 2018

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BackgroundChronic pancreatitis (CP) is a chronic inflammatory disease of the pancreas. This study aimed to compare the natural course of alcoholic chronic pancreatitis (ACP) and idiopathic chronic pancreatitis (ICP).MethodsCP patients admitted to our center from January 2000 to December 2013 were enrolled. Characteristics were compared between ACP and ICP patients. Cumulative rates of diabetes mellitus (DM), steatorrhea, pancreatic stone, pancreatic pseudocyst, biliary stricture, and pancreatic cancer after the onset and the diagnosis of CP were calculated, respectively. The cumulative rates of DM and steatorrhea after diagnosis of pancreatic stone were also calculated.ResultsA total of 2,037 patients were enrolled. Among them, 19.8% (404/2,037) were ACP and 80.2% (1,633/2,037) were ICP patients. ACP and ICP differs in many aspects, especially in gender, age, smoking, complications, morphology of pancreatic duct, and type of pain. The development of DM, steatorrhea, PPC, pancreatic stone, and biliary stricture were significantly earlier and more common in ACP patients. No significant difference was observed for pancreatic cancer development. There was a rather close correlation between exocrine/endocrine insufficiency and pancreatic stone in ACP patients, which was much less correlated in ICP patients.ConclusionThe long-term profile of ACP and ICP differs in some important aspects. ACP patients usually have a more severe course of CP. These differences should be recognized in the diagnosis and treatment of CP.

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Vanishing Pancreatic Calcification in Chronic Pancreatitis

Cited by 41 publications

References 6 publications

Studies on Pancreatic Stones

Studies on Pancreatic Stones

Chronic Pancreatitis in Zurich, 1963–1972

The different course of alcoholic and idiopathic chronic pancreatitis: A long-term study of 2,037 patients

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