Pancreatic Stones

[Guest guest]

Mehmet,

I am sorry to hear of your wife's condition. I am glad, however, that

you were able to locate the PAI website. I think you should find some

of this information helpful. At least, you will know that you are not

alone, as this can be such an overwhleming disease.

Fortunatly, it sounds as though this is your wife's first occurance of

a pancreatic stone. Do I understand that she has not had another one

previously? As the stone was too large to be removed by ERCP or

broken down by ESWL and is obstructing the main pancreatic duct, then

time is really of the essence ot have it removed in any manner

possible. At this time, it seems like everything has been ruled out

except for surgery.

You mentioned that she is on inuslin. Was she a diabetic prior to

this? Is she on insulin because she is on TPN or hyperalimentation

feedings? Or is she newly on insulin due to recent loss of pancreatic

function? The answers to these questions may facilitate the decision

on which surgery to have.

If she does not have substantial damage to the pancreas then one of

the surgery to open up the main pancreatic duct, remove the stone, and

re-route the pancreas to drain directly into the duodenum can have

excellent results. it depends on where in the main duct the stone is

lodged; near the head, the main body, or the tail.

The Puestow Procedure is a surgical procedure performed when the duct

within the pancreas becomes dilated and obstructed with a stone.

During the procedure, the duct is cleared and attached lengthwise to

the small intestine. This increases the amount of pancreatic enzymes

secreted into the small intestine.

The Whipple removes the head of the pancreas, along with part of the

stomach, and intestine. It is generally used for tumors of the

pancreatic head, but also when there is substantial disease to the

pancreatic head, or if there is a stone lodged in the head. There are

modified whipples depending on the extent of disease.

What is important to think about is that it may be that your wife's

pancreas is not necessarily diseased as with those who have chronic

pancreatitis. It may be that she simply has a large stone. It is

important to get the stone out as soon as possible, as it is the back

up of digestive juices that will cause irreversible organ and cell

damage.

Karyn , RN

Executive Director, PAI