title: Long-term follow-up study of surgical treatment for pancreatic stones.
abstract: OBJECTIVE
  With rare incidence and lack of extensive study for pancreatic stones, some issues in this area remain to be clarified. Surgical experience for pancreatic stones was presented, particularly focusing on the surgical risk and long-term outcome. We also evaluated the role of the pancreatic stone in pancreatitis and pancreatic cancer.
  
  
  METHODS
  Data of patients with pancreatic stones are analyzed between 1984 and 2002, with a median follow-up period of 67 months. Clinical features and characteristics of pancreas and pancreatic stone are evaluated. Diagnostic image studies are compared. Outcome measures are surgical risks including surgical morbidity and mortality, and degree of long-term symptom control.
  
  
  RESULTS
  There were 18 patients with pancreatic stones. The etiology was idiopathic in 50% of cases, and alcoholism in 33.3%. Abdominal pain was the most common (100%) clinical presentation. Pancreatic cancer was found in 4 (22.2%) patients. Most (61.1%) of the pancreatic stones were located in the pancreatic head. Only 1 patient had a single pancreatic stone, and 12 (66.7%) patients had more than 3 pancreatic stones. All the patients except one (94.4%) presented pictures of chronic pancreatitis. Surgical complication occurred in 2 (11.8%) patients, and surgical mortality in 1 (5.9%) resulting from pneumonia. Improvement of clinical symptoms after surgery was achieved in nearly all (93.8%) patients, including 56.3% free of symptoms, 25.0% much improvement and 12.5% mild improvement.
  
  
  CONCLUSIONS
  Removal of pancreatic stones combined with surgical drainage of pancreatic duct or resection of pancreas might have symptomatic benefits. Surgical intervention is recommended for all patients with pancreatic stones, in terms of symptom relief, cancer risk and low surgical risk.
authors.affiliation: Department of Surgery, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan.
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Fang
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Shyr
authors.forename: Cheng-Hsi
authors.initials: CH
authors.lastname: Su
authors.forename: Tien-Hua
authors.initials: TH
authors.lastname: Chen
authors.forename: Chew-Wun
authors.initials: CW
authors.lastname: Wu
authors.forename: Wing-Yiu
authors.initials: WY
authors.lastname: Lui
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002137:Calculi / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000150:complications / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000209:etiology