Pancreatic stones

Pancreatic calculi, once considered pathologic and even "reportable," are frequently observed in patients with chronic pancreatitis. They are not to be considered pathognomonic of chronic alcoholism, because they are frequently observed in other types of chronic pancreatitis, such as the tropical, Afro-Asian, hereditary, idiopathic, and senile varieties. The widely recognized concept that appearance of calculi indicates the end stage of the disease is challenged in this article. The subject of pancreatic lithogenesis is controversial, but pancreatic stone protein has been extensively studied by one major group. Techniques to remove calculi by endoscopy or extracorporeal shock wave lithotripsy are available, but it is not clear whether they serve only a cosmetic purpose or actually help in alleviating pain and arresting the progress of disease.