Gnecco James, Brown Landon K, Boregowda Umesha, Abidali Hussein, Saligram Shreyas, Rosenkranz Laura, Patel Sandeep, Haluskza Oleh, Sayana Hari
From the Department of Internal Medicine.
Division of Gastroenterology, University of Texas Health Science at San Antonio, San Antonio, TX.
Pancreas. 2022 Sep 1;51(8):916-922. doi: 10.1097/MPA.0000000000002129.
Pancreatic stones are sequelae of chronic pancreatitis, resulting in poor quality of life, frequent hospitalizations, and a significant economic burden. Extracorporeal shock wave lithotripsy (ESWL) can be used to treat pancreatic stones and is less invasive when compared to other modalities. In this review article, we have discussed the role of ESWL in the treatment of pancreatic stones and how it differs from other modalities. Databases were searched electronically for articles discussing the treatment of pancreatic ductal stones by ESWL or other modalities. Articles discussing or comparing treatment success rates were preferentially included. An inductive approach was used to identify articles related to the treatment of pancreatic stones with ESWL throughout the review process. Although laser lithotripsy and electrohydraulic lithotripsy appear to have higher success rates, the potential for ESWL to affect clinical outcomes is substantial, especially in individuals with a higher risk for invasive procedures. The decision to perform ESWL should be considered if the outcome will substantially alter the clinical management when performed by an experienced endoscopist. Further randomized controlled trials are needed to compare ESWL and peroral pancreatic lithotripsy methods.
胰腺结石是慢性胰腺炎的后遗症，会导致生活质量下降、频繁住院以及巨大的经济负担。体外冲击波碎石术（ESWL）可用于治疗胰腺结石，与其他治疗方式相比，其侵入性较小。在这篇综述文章中，我们讨论了ESWL在胰腺结石治疗中的作用以及它与其他治疗方式的不同之处。通过电子方式检索数据库，查找讨论ESWL或其他治疗方式治疗胰管结石的文章。优先纳入讨论或比较治疗成功率的文章。在整个综述过程中，采用归纳法识别与ESWL治疗胰腺结石相关的文章。尽管激光碎石术和液电碎石术似乎有更高的成功率，但ESWL影响临床结局的潜力很大，尤其是对于有更高侵入性手术风险的个体。如果由经验丰富的内镜医师进行ESWL能显著改变临床管理，那么就应考虑实施该治疗。需要进一步的随机对照试验来比较ESWL和经口胰腺碎石术方法。
