Department of Gastroenterology, Yamashita Hospital, Ichinomiya.
From the Department of Gastroenterology, Fujita Health University Bantane Hospital, Nagoya, Japan.
Pancreas. 2022 Feb 1;51(2):205-211. doi: 10.1097/MPA.0000000000001996.
While chronic pancreatitis associated with pancreatolithiasis presents with pain, exocrine and endocrine pancreatic functions worsen with time. We examined outcomes of nonsurgical treatment.
Between 1992 and 2020, we treated pancreatolithiasis nonsurgically in 165 patients with chronic pancreatitis using extracorporeal shock wave lithotripsy alone or followed by endoscopic procedures. The mean follow-up duration was 49 months (standard deviation, 56 months) and the age was 56 years (standard deviation, 13 years). The male:female ratio was 5.1:1 (138 men, 27 women). We followed treatment results including relief of abdominal pain, stone clearance and recurrence, and pancreatic exocrine function (bentiromide-p-aminobenzoic acid testing).
Treatment relieved pain in 117 of 124 patients (94%). The overall stone clearance was achieved in 130 of 165 patients (79%). Stones recurred during follow-up in 50 of 130 patients (38%). One fifth of recurrences were early, often involving stricture of the main pancreatic duct. After 1 year, 65% of the patients had improved or stable exocrine function.
Nonsurgical stone removal usually improved symptoms and preserved pancreatic exocrine function. Nonsurgical treatment with extracorporeal shock wave lithotripsy followed by endoscopic treatment if needed is useful as initial management for pancreatolithiasis.
与胰石症相关的慢性胰腺炎常表现为疼痛，随着时间的推移，外分泌和内分泌胰腺功能会恶化。我们检查了非手术治疗的结果。
在 1992 年至 2020 年间，我们使用体外冲击波碎石术单独或联合内镜治疗 165 例慢性胰腺炎胰石症患者，平均随访时间为 49 个月（标准差为 56 个月），年龄为 56 岁（标准差为 13 岁）。男女比例为 5.1:1（138 名男性，27 名女性）。我们随访了治疗结果，包括腹痛缓解、结石清除和复发以及胰腺外分泌功能（苯丁托咪啶-p-氨基苯甲酸试验）。
在 124 例腹痛患者中，117 例（94%）治疗后疼痛缓解。165 例患者中，130 例（79%）总体结石清除。在随访期间，50 例患者（38%）结石复发。五分之一的复发是早期的，常涉及主胰管狭窄。1 年后，65%的患者外分泌功能改善或稳定。
非手术结石清除通常可改善症状并保留胰腺外分泌功能。体外冲击波碎石术联合内镜治疗作为胰石症的初始治疗是有用的。
