Litotricia por ondas de choque extracorpóreas como tratamiento de los cálculos del conducto pancreático principal / Extracorporeal shock- wave lithotripsy as a treatment of the calculi of the main pancreatic duct

Las ondas de choque extracorpóreas se utilizan desde hace varios años con buenos resultados en la fragmentación de cálculos vesiculares y de las vías biliares en pacientes seleccionados. Cuando los cálculos del conducto pancreático principal no pueden extraerse endoscópicamente está indicada esta variante no quirúrgica. Se presentan 4 pacientes del sexo masculino, entre 41 y 55 años de edad, con antecedentes de alcoholismo y el diagnóstico de pancreatitis crónica con litiasis en el conducto principal, 3 de ellos con más de 1 cálculo, que recibieron ondas de choque generadas por el principio electromagnético. Todos fragmentaron. El paciente con cálculo único eliminó los fragmentos espontáneamente, mientras que en los 3 restantes fue necesario asociar la endoscopia para obtener la limpieza total de Wirsung . Durante el seguimiento de más de 5 años se constató la regresión de los síntomas, fundamentalmente del dolor, sin recidivas(AU)

The extracorporeal shock waves have been used for several years with good results in the fragmentation of calculi of the gallbladder and of the biliary tract in selected patients. When the calculi of the main pancreatic duct cannot be endoscopically removed, this non-surgical variant is indicated. 4 male patients aged 41-55 with alcoholism history and the diagnosis of chronic pancreatitis with lithiasis in the main duct are presented. 3 of them with more than a calculus received shock waves generated by electromagnetic principle. All the calculi were fragmented. The patient with only one calculus eliminated the fragments spontaneously, whereas in the other 3 it was necessary to associate endoscopy to obtain Wirsung's total cleaning. During the follow-up of more than 5 years it was proved the regression of the symptoms, mainly pain, without relapses(AU)

PANCREATIC LITHIASIS——REPORT OF 9 CASES / 中国普通外科杂志

This paper reported nine cases of pancreatic lithiasis. Pancreatolithotomy and pancreaticojejunostomy was performed in 4 cases; Pancreatoduodenectomy in 1 case; Laparotomy and biopsy in 1 case complicated with pancreatic carcinoma and hepatic metastasis; And nonoperative treatment in 3 cases. Our data showed that pancreatic fluid stasis caused by stenosis of pancreatic duct and/or the distal segment of bile duct maybe one of the important factors of pancreatic stone formation. The diagnosis and principles of surgical treatment of pancreatic lithiasis were discussed.