(Journal Article): The Value of a Pancreatogram in Chronic Pancreatitis Diagnosed by Endoscopic Retrograde Cholangiopancreatography
 
Hernández-Garcés HR, Lazo del Vallin S, Moutary I (National Institute of Gastroenterology. Havana, Cuba, hhgarces@infomed.sld.cu )
 
IN: JOP. J Pancreas (Online) 2004; 05(1):25-31

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ABSTRACT: 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.

TYPE OF PUBLICATION: Original Article