A CASE OF PANCREATIC PROTEIN PLUG AFTER PANCREATICODUODENECTOMY

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 64; no. 9; pp. 2280 - 2283
• Main Authors: TARAO, Makoto, MATSUTOMO, Masazumi, FUTAMURA, Naoki, ICHIHASHI, Masayoshi
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2003
• Subjects: protein plug
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.64.2280

A 64-year-old man with drinking habit was admitted to the hospital because of jaundice and abdominal pain. He was diagnosed as to have lower bile duct cancer and early cancer of the antrum, and underwent a pancreaticoduodenectomy. Postoperative pathological examination revealed that genesis of jaundice was not bile cancer but chronic pancreatitis. Thereafter he could not break the drinking habit, and five years after the first operation, he was admitted the hospital again for acute change of chronic pacreatitis. Abdominal CT scan and ultrasonography showed dilatation of the pancreatic duct without showing pancreatic stone shadow. As internal medical treatment was ineffective, reoperation was performed. When the pancreatic duct was opened, many small green soft concretions overflowed which were removed. Pancreatico-jejunostomy was performed with Roux-Y method. Chemical analysis revealed that the stone were composed of protein 96% and phosphorus 4%. These concretions were diagnosed as pancreatic protein plug. The patient's postoperative course has been uneventful.