Diagnosis and treatment of pancreatic duct stone / 中华胰腺病杂志

ABSTRACT

Objective To explore the methods of diagnosis and appropriate treatment of pancreatic duct stone.Methods Clinical data of 16 patients with pancreatic duct stone from March,2005 to August,2009 were analyzed retrospectively.Results 15 patients presented with varying degrees of upper abdominal pain,another one with irregular diarrhea.Serum and urine amylase level was higher than the upper limit of normal level in 3 patients;serum glucose was elevated in 4 patients.The diagnostic accuracy by Bultrasonography,CT,MRI,ERCP and KUB was 93.8%(15/16),68.8% (11/16),57.1% (4/7);100%(2/2) and 50% (3/6),respectively.2 cases underwent endoscopic pancreatic sphincterotomy + pancreatic stent drainage,14 cases were treated with surgery,including transpancreatic duct lithotomy + pancreatic jejunal anastomosis in 12 cases,pancreatoduodenectomy in 1 ease,and pancreatic body and tail resection +pancreatic jejunal Roux-en-Y anastomosis in one case.All operations were successful without mortality,and abdominal pain was significantly improved.Follow up of 14 cases showed no stone recurrence.Two patients were lost in follow up,so the follow up rate was 87.5% with the duration ranging from 1 to 53 months.Conclusions B-ultrasonography was the best imaging examination for pancreatic duet stone,but the combined application of imaging tests could significantly improve the diagnostic yield,and imaging examination provided an important basis for the choice of treatment method.With the improvement of endoscopic techniques,ERCP will be as important as surgery for the treatment of pancreatic duct stone.