Delhaye M, Vandermeeren A, Baize M, Cremer M
Medicosurgical Department of Gastroenterology, Erasme Hospital, Free University of Brussels, Belgium.
Gastroenterology. 1992 Feb;102(2):610-20. doi: 10.1016/0016-5085(92)90110-k.
Extracorporeal shock-wave lithotripsy (ESWL) has been used to disintegrate pancreatic stones located in the main pancreatic duct for 123 patients with severe chronic pancreatitis. Endoscopic management following ESWL is aimed at restoring the pancreatic flow to the duodenum. Stone disintegration was achieved in 122 patients, whereas a decrease in the main pancreatic duct diameter resulted in 111, and complete clearance of the main pancreatic duct was obtained in 72. Pain relief, complete (40/88) or partial (35/88), correlated significantly with the results of the endoscopic drainage of the main pancreatic duct (e.g., decrease in main pancreatic duct diameter). Relapsing pain was most often related to recurrent pancreatic duct obstruction. Of 76 patients whose body weight had decreased before ESWL, 54 gained weight. Improvement of the exocrine function, evaluated by the [14C]triolein breath test before and 11 months, on the average, after ESWL, was observed in 12 patients among 22 for whom this test was performed before and after treatment. Improvement of the endocrine function after relief of obstruction of the main pancreatic duct was less frequently recorded (4/41). ESWL of pancreatic stones is a new, safe, and highly effective method of facilitating the endoscopic procedures for relief of pancreatic duct obstruction in severe chronic pancreatitis.
体外冲击波碎石术（ESWL）已被用于为123例重症慢性胰腺炎患者粉碎位于主胰管的胰腺结石。ESWL后的内镜治疗旨在恢复胰腺向十二指肠的引流。122例患者实现了结石粉碎，111例患者主胰管直径减小，72例患者主胰管完全清除。疼痛缓解，完全缓解（40/88）或部分缓解（35/88），与主胰管内镜引流结果（如主胰管直径减小）显著相关。复发性疼痛最常与复发性胰管梗阻有关。在ESWL前体重下降的76例患者中，54例体重增加。在治疗前后进行[14C]三油酸甘油酯呼气试验评估外分泌功能，在22例接受该试验的患者中，平均ESWL后11个月，有12例患者外分泌功能得到改善。主胰管梗阻解除后内分泌功能改善的记录较少（4/41）。胰腺结石的ESWL是一种新的、安全且高效的方法，有助于在内镜下缓解重症慢性胰腺炎的胰管梗阻。
