[A case of the pancreatic duct change after a long-term pancreatic stenting in pancreas divisum and the fine structural analysis of occluded pancreatic polyethylene stent].
The pancreatic duct stenting is now recognized as the treatment option for a number of pancreatic disorders. Although the stent-induced ductal changes may result, there is little information regarding the frequency of these stent-induced changes in chronic pancreatitis. Pancreatic stents may occlude with time, but there is only little information available on the nature of the clogging process. Although a short-term efficacy of endoscopic pancreatic duct stenting has been proved, the long-term efficacy continues to be controversial. The aim of this study was to report a case of chronic pancreatitis with pancreatolith after the incidental long-term pancreatic stenting for 3 years due to a pancreas divisum with acute pancreatitis. Also, this study described the analysis of the ultrastructural changes in the surface of an occluded pancreatic stent. A scanning and transmission electron microscopy showed an amorphous protein matrix in whole stent that arranged as a network in some areas but arranged as the layers in other areas. A variable number of bacteria of mixed species, calcium carbonate or calcium oxalate crystal, round leukocyte were scattered in the protein matrix. The yeast and plant material were seen in some part of the stent as well.
Department of Internal Medicine, Hanyang University College of Medicine, Seongdong-gu, Seoul, Korea.
Jai Hoon
JH
Yoon
Ho Soon
HS
Choi
Sang Hyeon
SH
Baeg
Oh Young
OY
Lee
Byung Chul
BC
Yoon
Jung Kyun
JK
Kwon
Won Kyu
WK
Kim
D002760:Cholangiopancreatography, Endoscopic Retrograde; D006801:Humans; D020347:Lithiasis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities*; D010183:Pancreatic Ducts / Q000473:pathology*; D010195:Pancreatitis / Q000150:complications / Q000628:therapy*; D020959:Polyethylene; D015607:Stents / Q000009:adverse effects*
D020959:Polyethylene