Management of Pancreatolithiasis: A Nationwide Survey in Japan

被引：27

作者：

Inui, Kazuo ^{[1
]}

Masamune, Atsushi ^{[2
]}

Igarashi, Yoshinori ^{[3
]}

Ohara, Hirotaka ^{[4
]}

Tazuma, Susumu ^{[5
]}

Sugiyama, Masanori ^{[6
]}

Suzuki, Yutaka ^{[6
]}

Miyoshi, Hironao ^{[1
]}

Yamamoto, Satoshi ^{[1
]}

Takeyama, Yoshifumi ^{[7
]}

Nakano, Eriko ^{[2
]}

Takuma, Kensuke ^{[3
]}

Sakagami, Junichi ^{[8
]}

Hayashi, Kazuki ^{[9
]}

Kogure, Atsuko ^{[10
]}

Ito, Tetsuya ^{[11
]}

Mukai, Tsuyoshi ^{[12
]}

Maetani, Iruru ^{[13
]}

Nagahama, Masatsugu ^{[14
]}

Serikawa, Masahiro ^{[15
]}

Ueki, Toshiharu ^{[16
]}

Furuya, Ken ^{[17
]}

Isayama, Hiroyuki ^{[18
]}

Moriyama, Ichiro ^{[19
]}

Shigeno, Masaya ^{[20
]}

Mizukami, Kazuhiro ^{[21
]}

Nanashima, Atsushi ^{[22
]}

Oana, Shuhei ^{[23
]}

Ikehata, Atsushi ^{[24
]}

Watanabe, Noriko ^{[25
]}

Hirooka, Yoshiki ^{[26
]}

Ogoshi, Keiichiro ^{[27
]}

Sasaki, Yoji ^{[28
]}

Iwata, Yoshinori ^{[29
]}

Kudo, Yasushi ^{[30
]}

Nakayama, Ataru ^{[31
]}

Nakamura, Masafumi ^{[32
,33
]}

机构：

[1] Fujita Hlth Univ, Teaching Hosp 2, Dept Gastroenterol, Nagoya, Aichi, Japan

[2] Tohoku Univ, Div Gastroenterol, Grad Sch Med, Sendai, Miyagi, Japan

[3] Toho Univ, Div Gastroenterol & Hepatol, Omori Med Ctr, Tokyo, Japan

[4] Nagoya City Univ, Dept Community Based Med Educ, Grad Sch Med Sci, Nagoya, Aichi, Japan

[5] Hiroshima Univ, Dept Gen Internal Med, Grad Sch Med Sci, Hiroshima, Japan

[6] Kyorin Univ, Dept Surg, Sch Med, Tokyo, Japan

[7] Kindai Univ, Dept Surg, Sch Med, Osakasayama, Japan

[8] Kyoto Prefectural Univ Med, Dept Gastroenterol & Hepatol, Kyoto, Japan

[9] Nagoya City Univ, Dept Gastroenterol & Metab, Grad Sch Med Sci, Nagoya, Aichi, Japan

[10] Fujita Gen Hosp, Dept Gastroenterol, Fukushima, Japan

[11] Shinshu Univ, Dept Gastroenterol, Sch Med, Matsumoto, Nagano, Japan

[12] Gifu Municipal Hosp, Dept Gastroenterol, Gifu, Japan

[13] Toho Univ, Div Gastroenterol & Hepatol, Dept Internal Med, Ohashi Med Ctr, Tokyo, Japan

[14] Showa Univ, Dept Gastroenterol, Fujigaoka Hosp, Yokohama, Kanagawa, Japan

[15] Hiroshima Univ Hosp, Dept Gastroenterol & Metab, Hiroshima, Japan

[16] Fukuoka Univ, Dept Gastroenterol, Chikushi Hosp, Fukuoka, Japan

[17] Hokkaido Hosp, Community Hlth Care Org JCHO, Div Gastroenterol & Hepatol, Sapporo, Hokkaido, Japan

[18] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[19] Shimane Univ Hosp, Ctr Canc, Izumo, Shimane, Japan

[20] Japanese Red Cross Nagasaki Genbaku Hosp, Nagasaki, Japan

[21] Oita Univ, Dept Gastroenterol, Yufu, Japan

[22] Univ Miyazaki, Dept Surg, Miyazaki, Japan

[23] Iwate Med Univ, Div Gastroenterol, Dept Internal Med, Morioka, Iwate, Japan

[24] Iwate Cent Prefectural Hosp, Dept Gastroenterol, Morioka, Iwate, Japan

[25] NHO Mie Chuo Med Ctr, Dept Gastroenterol, Tsu, Mie, Japan

[26] Nagoya Univ Hosp, Dept Endoscopy, Nagoya, Aichi, Japan

[27] Natl Hosp Org Fukuoka Higashi Med Ctr, Dept Gastroenterol & Hepatol, Koga, Japan

[28] Konankosei Hosp, Konan, Japan

[29] Hyogo Coll Med, Dept Internal Med, Div Hepatobiliary & Pancreat Dis, Nishinomiya, Hyogo, Japan

[30] Kitano Hosp, Ctr Digest Dis, Osaka, Japan

[31] Ina Cent Hosp, Ina, Saitama, Japan

[32] Kyushu Univ, Grad Sch Med Sci, Dept Surg, Fukuoka, Fukuoka, Japan

[33] Kyushu Univ, Grad Sch Med Sci, Dept Oncol, Fukuoka, Fukuoka, Japan

来源：

PANCREAS | 2018年 / 47卷 / 06期

关键词：

chronic pancreatitis; endoscopic pancreatic sphincterotomy; endoscopic removal of pancreatic stones; extracorporeal shock-wave lithotripsy; pancreatic ductal decompression surgery; SHOCK-WAVE LITHOTRIPSY; PANCREATIC DUCT STONES; EPIDEMIOLOGIC SURVEY; ENDOSCOPIC TREATMENT; DIAGNOSTIC-CRITERIA; DISINTEGRATION; PATIENT;

D O I：

10.1097/MPA.0000000000001071

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives The aim of this study was to assess prevailing treatment of pancreatolithiasis in Japan. Methods We surveyed clinical data from 1834 patients (1479 men and 355 women) at 125 hospitals. Results Extracorporeal shock-wave lithotripsy (ESWL) was performed alone in 103 patients (5.6%), ESWL plus an endoscopic procedure in 446 (24.3%), endoscopic treatment alone in 261 (14.2%), and surgery in 167 (9.1%). Other treatments were given to 358 (19.5%), whereas 499 (27.2%) received no treatment. Symptoms were relieved in 85.7% after ESWL, 80.8% after endoscopic treatment alone, and 92.8% after surgery. Early complication rates within 3 months after ESWL, endoscopic treatment alone, and surgery were 8%, 4.5%, and 27.1%, respectively. Late complications after ESWL, endoscopic procedures alone, and surgery were 1.7%, 2.5%, and 8.2%, respectively. Symptom relief but also early and late complications were greater after surgery than after ESWL and endoscopic treatment. Among 417 patients undergoing ESWL, 61 (14.6%) required surgery, as did 32 (16%) of 200 patients treated endoscopically. Surgery was required less frequently following initial operative treatment (11/164 patients [6.7%]). Nonsurgical initial treatments were chosen more frequently. Conclusions First-line treatment of pancreatolithiasis should be ESWL with or without endoscopy because of minimal invasiveness and fewer complications.

引用

页码：708 / 714

页数：7

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