BACKGROUND: Pancreatolithiasis is rarely recognized clinically. This study was undertaken to assess the value of ultrasonography in the diagnosis of 16 patients with pancreatolithiasis and its treatment with pancreatolithotomy plus side-to-side pancreaticojejunostomy. Extracorporeal shock wave lithotripsy was also used in some patients.
METHODS: In the 16 patients with pancreatolithiasis treated at our hospital from 1977 to June 2002, 3 patients were complicated by pancreatic cancer, 2 pancreatic head cyst, and 1 choledochal cyst. Ten patients underwent operation, 3 received endoscopic sphincterotomy (EST), and 3 refused operation and left the hospital.
RESULTS: Epigastric pain was the major symptom of the disease. Ultrasonography was the best choice for the diagnosis of the disease in addition to CT for determining characteristics and location of pancreatolithiasis associated with pancreatic cancer, ERCP for showing pancreatic stone, and EST for detecting stone in the pancreatic head. Pancreatolithotomy plus side-to-side pancreaticojejunostomy was used for the treatment of pancreatolithiasis.
CONCLUSIONS: Ultrasonography is the first choice for the diagnosis of pancreatolithiasis. Pancreatolithotomy plus side-to-side pancreaticojejunostomy is the best choice for the treatment of pancreatolithiasis. CT is of great value in determining characteristics and locations of pancreatolithiasis associated with pancreatic cancer. For patients with pancreatolithiasis associated with pancreatic cancer, surgical treatment should follow the principles of individualized therapy.