Chronic pancreatitis with ductal stones in the pancreatic he
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Pancreatic duct stones are direct sequelae of chronic pancreatitis (CP) and can occur in 50% of patients. Selection of the appropriate treatment method for pancreatic duct stones depends on location, size and number of stones.

A 57-year-old man presented with a history of upper abdominal pain and weight loss for the previous 3 months. Diagnostic workup detected a chronic inflammation of the pancreas with stone in the main pancreatic duct and a nodular lesion in the head of the pancreas.

In this case, the team opted not to perform a total pancreatectomy due to the absence of lesions to the body and tail of the pancreas, rather a very focal cystic lesion to the head, causing fluid stasis and stone formation inside the main pancreatic duct. Pancreaticoduodenectomy in patients with CP is a feasible option for the treatment of focal cystic lesions to the head of the pancreas associated to pancreatic stone in selected cases.

Endoscopic retrograde cholangiopancreatography was performed intended to extract stones and drain the main pancreatic duct. Unfortunately, the procedure was unsuccessful for stones removal.
A pancreaticoduodenectomy was then performed. A drain was placed in the surgical area. At 6 months of follow-up, the patient was completely asymptomatic.

Given the rise in incidence and prevalence of CP, the potential complications and high mortality rate, it is imperative that physicians understand the risk factors, disease process and management of this disease.

Source:
https://academic.oup.com/jscr/article/2020/10/rjaa352/5918937
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