Evolution and regression of pancreatic calcification in chronic pancreatitis. A prospective long-term study of 107 XXXX .

@entity1 @entity788 @entity1689 @entity8883 @entity660 @entity730
Pancreatic @entity730 are virtually pathognomonic of chronic @entity788 and develop in up to 90% of @entity1 with @entity8883 in series with long-term results. We investigated the natural course of pancreatic @entity730 in a prospective longitudinal study over the past 23 yr. All @entity1 were studied at regular intervals with particular regard to etiology, clinical findings, surgery, pancreatic function, and pancreatic @entity730 visible by x-ray (e.g., film series in three projections centered on the pancreas). We evaluated the findings of 107 @entity1 with x-ray documentation of pancreatic @entity730 in at least three film series over a period of 4 yr or longer. Eighty-four @entity1 had @entity8883 (group A) and 23 @entity1 had @entity1689 (group B). Four hundred seventy-two film series of group A and one hundred forty-two film series of group B were reviewed independently by two expert teams. Both series were graded according to a score system in terms of intensity and distribution of pancreatic @entity730 (correlation of grading r = 0.91). The duration of @entity730 averaged 10 yr in group A and 12.6 yr in group B. Similar dynamic changes of pancreatic @entity730 were noted in groups A and B. Chronologically, three phases of evolution could be distinguished. After an initial increase (phase 1), greater than 50% of cases reached a plateau of stationary @entity730 (phase 2). Approximately one-third of cases showed a marked decrease of @entity730 in late phases of chronic @entity788 (phase 3). Dissolution of pancreatic stones was related primarily to duration of chronic @entity788 (duration of @entity730 and marked @entity660 ), and occurred frequently (but not exclusively) in @entity1 after ductal drainage procedures. These results indicate that spontaneous dissolution of pancreatic stones is a rather common biologic phenomenon. The factors responsible for dissolution of stones remain to be elucidated.
