title: Pancreatic duct stones in patients with chronic pancreatitis: surgical outcomes.
abstract: BACKGROUND
  Pancreatic duct stone (PDS) is a common complication of chronic pancreatitis. Surgery is a common therapeutic option for PDS. In this study we assessed the surgical procedures for PDS in patients with chronic pancreatitis at our hospital.
  
  
  METHODS
  Between January 2004 and September 2009, medical records from 35 patients diagnosed with PDS associated with chronic pancreatitis were retrospectively reviewed and the patients were followed up for up to 67 months.
  
  
  RESULTS
  The 35 patients underwent ultrasonography, computed tomography, or both, with an overall accuracy rate of 85.7%. Of these patients, 31 underwent the modified Puestow procedure, 2 underwent the Whipple procedure, 1 underwent simple stone removal by duct incision, and 1 underwent pancreatic abscess drainage. Of the 35 patients, 28 were followed up for 4-67 months. There was no postoperative death before discharge or during follow-up. After the modified Puestow procedure, abdominal pain was reduced in patients with complete or incomplete stone clearance (P>0.05). Steatorrhea and diabetes mellitus developed in several patients during a long-term follow-up.
  
  
  CONCLUSIONS
  Surgery, especially the modified Puestow procedure, is effective and safe for patients with PDS associated with chronic pancreatitis. Decompression of intraductal pressure rather than complete clearance of all stones predicts postoperative outcome.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Bo-Nan
authors.initials: BN
authors.lastname: Liu
authors.forename: Tai-Ping
authors.initials: TP
authors.lastname: Zhang
authors.forename: Yu-Pei
authors.initials: YP
authors.lastname: Zhao
authors.forename: Quan
authors.initials: Q
authors.lastname: Liao
authors.forename: Meng-Hua
authors.initials: MH
authors.lastname: Dai
authors.forename: Han-Xiang
authors.initials: HX
authors.lastname: Zhan
mesh_terms: D000293:Adolescent; D000328:Adult; D002137:Calculi / Q000209:etiology* / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D010183:Pancreatic Ducts / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D045602:Steatorrhea / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult