Tao Tao, Zhang Qi-Jie, Zhang Ming, Zhu Xiao, Sun Shu-Xia, Li Yan-Qing
Tao Tao, Yan-Qing Li, Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
World J Gastroenterol. 2014 Aug 7;20(29):10121-7. doi: 10.3748/wjg.v20.i29.10121.
To evaluate the effect of cholecystokinin (CCK) during extracorporeal shockwave lithotripsy (ESWL) in the clearance of common bile duct (CBD) stones in endoscopic retrograde cholangiopancreatography (ERCP).
Between January 2007 and September 2012, patients with large CBD stones who were treated with ESWL and ERCP were identified retrospectively. Patients were randomized in equal numbers to cholecystokinin (CCK) and no CCK groups. For each CCK case, a dose (3 ng/kg per min for 10 min) of sulfated octapeptide of CCK-8 was administered intravenously near the beginning of ESWL. ERCP was performed 4 h after a session of ESWL. The clearance rate of the CBD was assessed between the two groups.
A total of 148 consecutive cases (CCK group: 74, no CCK group: 74) were tallied. Overall there were 234 ESWLs and 228 ERCPs in the 148 cases. The use of CCK showed a significantly higher rate of successful stone removal in the first ESWL/ERCP procedure (71.6% vs 55.4%, P = 0.035), but resulted in similar outcomes in the second (42.8% vs 39.4%) and third (41.7% vs 40.0%) sessions, as well as total stone clearance (90.5% vs 83.8%). The use of mechanical lithotripsy was reduced in the CCK group (6.8% vs 17.6%, P = 0.023), and extremely large stone (≥ 30 mm) removal was higher in the CCK group (72.7% vs 41.7%, P = 0.038).
CCK during ESWL can aid with the clearance of CBD stones in the first ESWL/ERCP session. Mechanical lithotripsy usage was reduced and the extremely large stone (≥ 30 mm) clearance rate can be raised.
评估在体外冲击波碎石术（ESWL）期间使用胆囊收缩素（CCK）对经内镜逆行胰胆管造影术（ERCP）中胆总管（CBD）结石清除率的影响。
回顾性分析2007年1月至2012年9月期间接受ESWL和ERCP治疗的胆总管大结石患者。将患者随机分为CCK组和非CCK组，每组人数相等。对于每个CCK组病例，在ESWL开始时静脉注射剂量为3 ng/kg每分钟共10分钟的CCK-8硫酸化八肽。在一次ESWL治疗后4小时进行ERCP。评估两组之间CBD的结石清除率。
共统计148例连续病例（CCK组：74例，非CCK组：74例）。148例患者共进行了234次ESWL和228次ERCP。在首次ESWL/ERCP手术中，使用CCK的结石清除成功率显著更高（71.6%对55.4%，P = 0.035），但在第二次（42.8%对39.4%）和第三次（41.7%对40.0%）手术以及总结石清除率方面结果相似（90.5%对83.8%）。CCK组机械碎石的使用减少（6.8%对17.6%，P = 0.023），CCK组中极大型结石（≥30 mm）的清除率更高（72.7%对41.7%，P = 0.038）。
ESWL期间使用CCK有助于在首次ESWL/ERCP手术中清除CBD结石。减少了机械碎石的使用，并提高了极大型结石（≥30 mm）的清除率。
