Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 4, July, p. 609–613

doi: 10.17219/acem/62687

PubMed ID: 28691427

Publication type: original article

Language: English

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Pancreatic duct stones: A report on 16 cases

Magdalena Panek-Jeziorna1,B,C,D,F, Jarosław Wierzbicki2,B,C,D,F, Abdulhabib Annabhani1,B,C,F, Leszek Paradowski1,A,E,F, Agata Mulak1,C,D,E,F

1 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

2 Department of Minimally Invasive Surgery and Proctology, Wroclaw Medical University, Poland

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.
Conclusion. 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.

Key words

pancreatic duct stone, pancreatolithiasis, chronic pancreatitis, endoscopic retrograde cholangiopancreatography

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