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体外冲击波碎石术治疗胰腺手术后合并结石的慢性胰腺炎患者

Extracorporeal Shock Wave Lithotripsy for Chronic Pancreatitis Patients With Stones After Pancreatic Surgery.

作者信息

Wang Dan, Ji Jun-Tao, Xin Lei, Bi Ya-Wei, Pan Jun, Liao Zhuan, Du Ting-Ting, Lin Jin-Huan, Zhang Di, Zeng Xiang-Peng, Ye Bo, Zou Wen-Bin, Chen Hui, Xie Ting, Li Bai-Rong, Zheng Zhao-Hong, Li Zhao-Shen, Hu Liang-Hao

出版信息

Pancreas. 2018 May/Jun;47(5):609-616. doi: 10.1097/MPA.0000000000001042.

Abstract

OBJECTIVES

The objective of this study was to evaluate the safety and efficacy of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) in chronic pancreatitis (CP) patients with pancreatic stones after previous pancreatic surgery.

METHODS

This is a single-center study prospectively conducted in pained CP patients undergoing P-ESWL. Patients with a pancreatic surgery history (PSH) were included in the PSH group, and patients without a PSH during the same period were assigned to the control group. The primary outcomes included complications associated with P-ESWL and pain relief. Secondary outcomes included stone clearance and improved quality-of-life scores.

RESULTS

From March 2011 to October 2014, P-ESWLs were performed on 1017 patients (50 in the PSH group, 967 in the control group). No significant difference was observed in the frequency of occurrence of P-ESWL complications between the PSH group and control group (14.0% vs 13.2%, P = 0.877). At follow-up (2.6 years; range, 1.0-4.5 years), pain relief was achieved in 36 patients (75.0%), and 37 patients (77.1%) experienced complete stone clearance. No significant differences were observed between these patients and the matched controls.

CONCLUSIONS

For CP patients who develop painful stones after pancreatic surgery, P-ESWL safely achieves significant pain relief and stone clearance, preventing the need for a repeat surgery.

摘要

目的

本研究旨在评估体外冲击波碎石术(P-ESWL)对既往接受过胰腺手术的慢性胰腺炎(CP)合并胰腺结石患者的安全性和有效性。

方法

这是一项在接受P-ESWL治疗的疼痛性CP患者中进行的单中心前瞻性研究。有胰腺手术史(PSH)的患者纳入PSH组,同期无PSH的患者分配至对照组。主要结局包括与P-ESWL相关的并发症和疼痛缓解。次要结局包括结石清除和生活质量评分改善。

结果

2011年3月至2014年10月,对1017例患者进行了P-ESWL治疗(PSH组50例,对照组967例)。PSH组和对照组之间P-ESWL并发症的发生率无显著差异(14.0%对13.2%,P = 0.877)。随访(2.6年;范围1.0 - 4.5年)时,36例患者(75.0%)疼痛缓解,37例患者(77.1%)结石完全清除。这些患者与匹配的对照组之间未观察到显著差异。

结论

对于胰腺手术后出现疼痛性结石的CP患者,P-ESWL能安全地实现显著的疼痛缓解和结石清除,避免了再次手术的需要。

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