中国患者体外冲击波碎石治疗胰腺结石：214例前瞻性研究

Extracorporeal Shock Wave Lithotripsy for Chinese Patients With Pancreatic Stones: A Prospective Study of 214 Cases.

作者信息

Hu Liang-Hao, Ye Bo, Yang Yu-Guang, Ji Jun-Tao, Zou Wen-Bin, Du Ting-Ting, Hao Jun-Feng, Jiang Ying-Yi, Liao Zhuan, Li Zhao-Shen

机构信息

From the *Department of Gastroenterology, †Digestive Endoscopy Center, and ‡Department of Anesthesiology, Changhai Hospital, The Second Military Medical University, Shanghai, China.

出版信息

Pancreas. 2016 Feb;45(2):298-305. doi: 10.1097/MPA.0000000000000464.

DOI:10.1097/MPA.0000000000000464

PMID:26418906

Abstract

OBJECTIVES

This study aims to evaluate prospectively the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) in Chinese patients.

METHODS

A total of 214 patients with painful chronic pancreatitis and pancreatic stones who underwent ESWL followed by endoscopic retrograde cholangiopancreatography from March 2011 to February 2012 in Changhai Hospital were enrolled. The main pancreatic duct clearance rate and complications were recorded prospectively. Symptoms, weight, quality of life, and pancreatic function were assessed before and after ESWL and endotherapy.

RESULTS

A total of 473 ESWL procedures were performed in 214 patients. Stones were fragmented in all cases. Complete clearance of main pancreatic duct stones and successful endoscopic decompression were achieved in 155 (72.4%) and 188 (90.8%) of 214 patients, respectively. Complications were observed after 20 sessions (20 of 473, 4.23%). Follow-up (n = 195) after 18.5 ± 3.3 months showed that complete and partial pain relief were achieved in 71.3% and 24.0% of the patients, respectively. The scores for the quality of life (5.8 ± 1.7 vs 8.1 ± 1.2, P < 0.05) and mental health from the Medical Outcomes Study 36-Item Short-Form General Health Survey questionnaire (62.2 ± 21.5 vs 68.5 ± 16.4, P < 0.05) improved after ESWL.

CONCLUSIONS

Thus, ESWL is a safe and effective method to treat Chinese patients with pancreatic stones. This procedure can significantly improve the success rate of endotherapy.

摘要

目的

本研究旨在前瞻性评估体外冲击波碎石术（ESWL）在中国患者中的安全性和有效性。

方法

纳入2011年3月至2012年2月在长海医院接受ESWL治疗并随后进行内镜逆行胰胆管造影术的214例疼痛性慢性胰腺炎和胰腺结石患者。前瞻性记录主胰管清除率和并发症情况。在ESWL和内镜治疗前后评估症状、体重、生活质量和胰腺功能。

结果

214例患者共进行了473次ESWL治疗。所有病例结石均被击碎。214例患者中，分别有155例（72.4%）主胰管结石完全清除，188例（90.8%）成功进行了内镜减压。473次治疗中有20次（20/473，4.23%）观察到并发症。18.5±3.3个月的随访（n = 195）显示，分别有71.3%和24.0%的患者疼痛完全缓解和部分缓解。ESWL后，医学结局研究36项简短健康调查问卷的生活质量评分（5.8±1.7对8.1±1.2，P < 0.05）和心理健康评分（62.2±21.5对68.5±16.4，P < 0.05）有所改善。