title: Endoscopic versus surgical treatment of downstream pancreatic duct stones in chronic pancreatitis.
abstract: Pancreatic duct stone is thought not only to be the cause of abdominal pain but also to be a risk factor for pancreatic cancer. Several treatment options have been implemented in the treatment of pancreatic duct stones. Stone location is a critical factor in selecting treatment. We  present the results of 27 endoscopic treatments and 35 surgical treatments performed in three hospitals at a single university between January 2000 and January 2005. The results were compared retrospectively in terms of success rate of stone removal, length of hospital stay, complications,  pain relief, and changes of pancreatic functions. In our study, endoscopy resulted in a similar success rate of stone removal and short-term pain relief rate as the surgical approach and with a shorter length of hospital stay. However, the surgical group had a more favorable long-term clinical  result, as well as a lower number of hospital readmissions at the 5-year follow-up point. Based on long-term results, surgical treatment is more effective than endoscopy.
authors.affiliation: Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Hong
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Alex M
authors.initials: AM
authors.lastname: Keleman
authors.forename: David K
authors.initials: DK
authors.lastname: Imagawa
authors.forename: Kesen
authors.initials: K
authors.lastname: Xu
authors.forename: Wenhua
authors.initials: W
authors.lastname: Wang
authors.forename: Enyu
authors.initials: E
authors.lastname: Liu
authors.forename: Weibo
authors.initials: W
authors.lastname: Niu
authors.forename: Jinshen
authors.initials: J
authors.lastname: Wang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Sun
authors.forename: Jiayong
authors.initials: J
authors.lastname: Wang
authors.forename: Cheng
authors.initials: C
authors.lastname: Peng
authors.forename: Wanni
authors.initials: W
authors.lastname: Zhao
authors.forename: Jun
authors.initials: J
authors.lastname: Niu
mesh_terms: D002137:Calculi / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002681:China / Q000453:epidemiology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D010183:Pancreatic Ducts / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome