Pancreatic duct stones in patients with chronic pancreatitis: surgical outcomes.
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.
Liu
Bo-Nan
BN
Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Zhang
Tai-Ping
TP
Zhao
Yu-Pei
YP
Liao
Quan
Q
Dai
Meng-Hua
MH
Zhan
Han-Xiang
HX
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