JOP : Journal of the pancreas · 2004
The value of a pancreatogram in chronic pancreatitis diagnosed by endoscopic retrograde cholangiopancreatography.
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Hernández Garcés Héctor R, Lazo del Vallin Sacha, Moutary Issoufou
Аннотация
CONTEXT: The presence, course and shape of the accessory pancreatic duct have not been previously studied in patients with chronic pancreatitis.
OBJECTIVES: The accessory pancreatic duct exhibits several appearances on pancreatography. It was examined using dye-injection endoscopic retrograde cholangiopancreatography, and the duct course and shape were studied in patients having chronic pancreatitis and were compared to patients with normal pancreatogram.
DESIGN: A prospective comparative study was carried out.
PATIENTS: One hundred and 57 consecutive patients (79 males and 78 females) who underwent endoscopic retrograde cholangiopancreatography for suspicion of pancreatobiliary disease.
SETTING: Forty-eight patients were diagnosed as having chronic pancreatitis using endoscopic retrograde cholangiopancreatography (28 alcoholic, 4 metabolic, and 16 idiopathic) and 109 patients had a normal pancreatogram.
MAIN OUTCOME MEASURES: The insertion type of the accessory pancreatic duct to the main pancreatic duct was determined and the terminal portion of the accessory pancreatic duct was described in both groups.
RESULTS: In patients with chronic pancreatitis, the insertion of the accessory pancreatic duct of short type prevailed; 31 patients (64.6%), independently of the degree of intensity of chronic pancreatitis. However, in patients with a normal pancreatogram, the intermediate and long type prevailed, 46 (42.2%) and 41 (37.6%) patients, respectively. In patients with a normal pancreatogram Stick type termination occurred in 66 patients (60.0%), and in patients having chronic pancreatitis, the Cudgel type was present in 34 patients (70.8%) which was statistically significant.
CONCLUSION: The accessory pancreatic duct should be analyzed when we carry out the cholangiopancreatography because the patients with short type insertion have a higher risk of developing chronic pancreatitis.
OBJECTIVES: The accessory pancreatic duct exhibits several appearances on pancreatography. It was examined using dye-injection endoscopic retrograde cholangiopancreatography, and the duct course and shape were studied in patients having chronic pancreatitis and were compared to patients with normal pancreatogram.
DESIGN: A prospective comparative study was carried out.
PATIENTS: One hundred and 57 consecutive patients (79 males and 78 females) who underwent endoscopic retrograde cholangiopancreatography for suspicion of pancreatobiliary disease.
SETTING: Forty-eight patients were diagnosed as having chronic pancreatitis using endoscopic retrograde cholangiopancreatography (28 alcoholic, 4 metabolic, and 16 idiopathic) and 109 patients had a normal pancreatogram.
MAIN OUTCOME MEASURES: The insertion type of the accessory pancreatic duct to the main pancreatic duct was determined and the terminal portion of the accessory pancreatic duct was described in both groups.
RESULTS: In patients with chronic pancreatitis, the insertion of the accessory pancreatic duct of short type prevailed; 31 patients (64.6%), independently of the degree of intensity of chronic pancreatitis. However, in patients with a normal pancreatogram, the intermediate and long type prevailed, 46 (42.2%) and 41 (37.6%) patients, respectively. In patients with a normal pancreatogram Stick type termination occurred in 66 patients (60.0%), and in patients having chronic pancreatitis, the Cudgel type was present in 34 patients (70.8%) which was statistically significant.
CONCLUSION: The accessory pancreatic duct should be analyzed when we carry out the cholangiopancreatography because the patients with short type insertion have a higher risk of developing chronic pancreatitis.