Japanese Study Group for Pancreato-Biliary Lithiasis, Japan.
Pancreas. 2013 May;42(4):584-8. doi: 10.1097/MPA.0b013e31827308c8.
A Japanese multicenter study of pancreatolithiasis was performed to investigate its clinical features and determine treatment strategies for pancreatolithiasis.
A retrospective study was performed on 916 patients managed in 34 institutions for a period of more than 5 years.
The treatment methods were extracorporeal shock wave lithotripsy (ESWL) in 479 patients, surgery in 133, and endoscopy alone in 68. Fragmentation of stones after ESWL was achieved in 92.4% of the patients. However, complete stone clearance was achieved in 49.4% of the patients after ESWL alone. The complete stone clearance rate was lower after ESWL than after endoscopy (87.9%). The incidence of early complications was significantly higher after surgery (13.3%) than after ESWL (6.1%). The frequencies of total stone recurrence after ESWL (22.5%) and endoscopy (12.0%) were significantly higher than that after surgery (1.5%). After ESWL (17.6%), abdominal pain recurred significantly more frequently than after surgery (2.2%). Stones and abdominal pain most often recurred within 3 years after ESWL and endoscopy.
First-line treatment of pancreatic stones should be ESWL alone or with endoscopy because of its minimal invasiveness and low incidence of early complications. Surgery should be performed on patients in whom ESWL and endoscopy failed.
日本进行了一项关于胰结石病的多中心研究，旨在调查其临床特征，并确定胰结石病的治疗策略。
对 34 家机构治疗的超过 5 年的 916 例患者进行回顾性研究。
479 例患者采用体外冲击波碎石术（ESWL）治疗，133 例患者采用手术治疗，68 例患者单独采用内镜治疗。ESWL 后结石碎裂率为 92.4%。然而，单独 ESWL 后完全清除结石的比例为 49.4%。ESWL 后完全清除结石的比例低于内镜治疗（87.9%）。手术（13.3%）后早期并发症的发生率明显高于 ESWL（6.1%）。ESWL（22.5%）和内镜治疗（12.0%）后的总结石复发率明显高于手术（1.5%）。ESWL 后（17.6%）腹痛复发明显更频繁，而手术（2.2%）后腹痛复发较少。ESWL 和内镜治疗后，结石和腹痛最常于 3 年内复发。
鉴于 ESWL 和内镜治疗具有微创性和低早期并发症发生率，应将其作为胰石症的一线治疗方法。对于 ESWL 和内镜治疗失败的患者，应进行手术治疗。
