Successful endoscopic removal of a rare, large impacted pancreatic duct stone using grasping forceps

Liu, Qin; Wang, Yiping; Zeng, Hong-Ze; Hu, Bing

doi:10.1097/md.0000000000010304

Cited by 2 publications

(6 citation statements)

References 19 publications

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“…Pancreatic calculi (PC) or pancreatolithiasis can occur during the natural development of CP due to its pathophysiology of increased parenchymal pressures and repeated episodes of severe epigastric pain [ 11 , 16 ]. However, pain in PDSs can originate from ischemia, nerve compression, and central hypersensitivity, explaining its perseverance in a few cases, even with full clearance of the duct [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…While the exact cause of pancreatic stone formation remains unclear, it is related to a decreased level of pancreatic stone protein (PSP) followed by supersaturation of pancreatic juice with calcium carbonate [ 9 ]. Pancreatic duct stones (PDSs) typically cause obstruction, and, consequently, hyper-tension of the distal part of the duct, elevated parenchymal pressure, ischemia, and inflammation of the pancreatic nerves, which can cause abdominal pain, insufficient exocrine pancreatic function, and other complications such as obstructive jaundice, diabetes, and steatorrhea [ 10 , 11 ]. Pancreatic pain is associated with a reduced quality of life, as it is sometimes combined with weight loss and low work productivity, and is regularly treated with opiates, which can cause dependence and hospitalization [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Pancreatic duct stones (PDSs) typically cause obstruction, and, consequently, hyper-tension of the distal part of the duct, elevated parenchymal pressure, ischemia, and inflammation of the pancreatic nerves, which can cause abdominal pain, insufficient exocrine pancreatic function, and other complications such as obstructive jaundice, diabetes, and steatorrhea [ 10 , 11 ]. Pancreatic pain is associated with a reduced quality of life, as it is sometimes combined with weight loss and low work productivity, and is regularly treated with opiates, which can cause dependence and hospitalization [ 11 , 12 ]. Consequently, it is essential to restore pancreatic duct flow, either with medical, endoscopic, or surgical therapy [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Pancreatolithiasis: Does Management Depend on Clinical Manifestations?

Paramythiotis,

Karlafti,

Kollatou

et al. 2024

Am J Case Rep

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Case series Patients: Male, 78-year-old • Female, 27-year-old Final Diagnosis: Pancreatic duct stones Symptoms: Abdominal pain Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Pancreatic calculi (PC) or pancreatolithiasis refers to the presence of stones in the main pancreatic duct (MPD), side branches, or parenchyma of the pancreas. It is highly associated with chronic pancreatitis (CP), and is present in 50-90% of those patients. The stone formation can be attributed to a diversity of factors, all of them leading to obstruction in the duct, hypertension of its distal part, increased intraductal and parenchymal pressure, and inflammation, causing the standard symptom, epigastric pain. Immediate restoration of pancreatic secretion flow is of utmost importance and can be achieved with both endoscopic and surgical techniques. Endoscopic techniques include endoscopic retrograde cholangiopancreatography (ERCP) combined, if possible, with extracorporeal shock wave lithotripsy (ESWL), while surgical techniques consist of drainage and resection procedures. The choice of treatment for PC depends on the location, size, and number of stones, and the existence of other complications. Case Reports: We present 2 cases that were diagnosed with PC, in which clinical symptoms, laboratory results, and imaging examinations were different, suggesting the variety of manifestations pancreatolithiasis can cause. Each patient was treated differently, according to their clinical situation and the presence or absence of complications. Both patients were discharged and fully recovered. Conclusions: The management of pancreatolithiasis can be demanding in some cases, mostly when there are complications. The purpose of this case report is to indicate the importance of personalized treatment for each patient, as different approaches to the same medical condition should be easily identified and successfully treated.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pancreatolithiasis: Does Management Depend on Clinical Manifestations?

Paramythiotis,

Karlafti,

Kollatou

et al. 2024

Am J Case Rep

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“…Another description of pancreatic relations is the following example: "A 3-cm hypovascular mass accompanying a large distal pseudocyst in the pancreatic tail" by Hamada et al [3]. In that paper, the authors refer to the same situation as described by Liu et al [5]. The part of pancreatic duct after head resection is called distal pancreatic duct.…”

mentioning

confidence: 99%

“…The description of pancreatic duct occlusion with proximal distension means that the part of pancreas between occlusion and tail is involved. "Dilatation of the pancreatic duct proximal to the tumour…" means left to the tumour or "The abdominal computed tomography scan revealed dilation of the proximal pancreatic duct with an irregular high density calcification shadow located at the head of the pancreas" [5]. On the other hand, the resection of pancreas is sometimes called "distal pancreatic resection", which means that left part of the gland is removed [1,9].…”

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confidence: 99%