| BackgroundPancreatic duct stone (PDS) is a rare diease, science PDS was firstly described by De Graaf in 1667, plenty of scholars and specialists have done a lot of profound study to understand the cause、pathogenesis、clinical manifestation、the method of diagnosis、the therapy and the prognosis. With the fast develop of image diagnostics, especially the emergence of MRCP、ERCP and CT, the detection rate of PDS increased year by year. Although the incidence of PDS is very low, but it may cause serious consequence, such as worsening chronic pancreatitis, inrreversible damage of pancreas, even lead to pancreatic cancer, therefore, the diagnosis and treatment gradually attract more and more attention.ObjectiveTo summarize the experience of diagnosis and treatment of pancreatic duct stone, improve the level of diagnosis and treatment of pancreatic duct stones.MethodsThe clinical data of 32 cases with pancreatic duct stones which had been treated by surgery or endoscopic in our hospital from 2001 to 2013 were retrospectively analyzed. collect patients’ age, gender, medical history, clinical symptoms, the methods of surgical and endoscopic treatment, hospitalization, prognosis and other basic information, according to different treatment method, patients were divided into surgery group and endoscopic group, and the statistical analysis was carried out by SPSS for Windows 19.0, comparison the clinical efficacy of surgery group and endoscopic group, T-test was conducted to process the data gained from each group, counts the material to use the χ2 examination.ResultsTwenty-five cases in 32 were male and seven were female, the ratio to male to female is 3.6:1, the mean age of the 20 patients is 39.47 years old (23-67). Among the 32 cases, all cases had abdominal pain, and chronic pancreatitis was associated, lumbar and back pain in 24 (75%), colic or megalgia in 2 (6.25%), diarrhea in 9 (28.12%), weight loss in 15 (46.88%), Diabetes Mellitus in 4 (12.5%), icterus in 1 (3.13%), fever in 3 (9.4%). The laboratory tests findings included fasting blood glucose and urine glucose elevation in 4 (12.5%), elevation of serum amylase level in 9 (28.12%), elevation of urine amylase values in 8 (25%), elevation of serum bilirubin in 1 (3.13%), other laboratory examination were negative. Before operation, the positive rates of B-ultrasonography, CT, ERCP and MRCP were 86.7%,93.3%,85.7% and 100%.32 cases were all treated by surgical or endoscopic treatment, and surgery group 20 cases, endoscopic group 12 cases. In the length of hospital stay had significant differences, the hospitalization time of endoscopic group was shorter than that of surgery group (P<0.05). there were no significant differences in age, course of disease and follow-up time (P>0.05). Surgery group and Endoscopic group had significant differences in abdominal pain (P<0.05), surgery group was superior to endoscopic group, and there were no significant differences in the diarrhea and weight loss and Diabetes Mellitus (P>0.05). The follow-up lasted 39 months in average (2-60 months).7 cases recovered partially after the treatment and 23 cases recovered completely. No recurrent signs were found in the surgery group,2 cases recurred in endoscopic group after 12 months and 20 months, treated by endoscopic again, till the end of the follow-up no recurrent signs was found.2 cases died, one of the surgery group died of acute myocardial infraction in the third month, one case died of pancreatic cancer in endoscopic group after 15 months later.ConclusionMRCP as a non-invasive examination is the first choice in the diagnosis of Pancreatic duct stones. According to the clinical classification of pancreatic duct stones, the individual treatment can get a good curative effect; Endoscopic therapy is also one of the methods of pancreatic duct stones treatment. |
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