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Pancreas. 2018 Jul;47(6):708-714. doi: 10.1097/MPA.0000000000001071.

Management of Pancreatolithiasis: A Nationwide Survey in Japan.

Author information

1
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai.
2
Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo.
3
Department of Community-Based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya.
4
Department of General Internal Medicine, Hiroshima University Graduate School of Medical Science, Hiroshima.
5
Department of Surgery, Kyorin University School of Medicine, Tokyo.
6
Department of Surgery, Kindai University School of Medicine, Osakasayama.
7
Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto.
8
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya.
9
Department of Gastroenterology, Fujita General Hospital, Fukushima.
10
Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto.
11
Department of Gastroenterology, Gifu Municipal Hospital, Gifu.
12
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo.
13
Department of Gastroenterology, Showa University Fujigaoka Hospital, Yokohama.
14
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima.
15
Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka.
16
Division of Gastroenterology and Hepatology Community Health Care Organization (JCHO) Hokkaido Hospital, Sapporo.
17
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo.
18
Shimane University Hospital Cancer Center, Izumo.
19
The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki.
20
Department of Gastroenterology, Oita University, Yufu.
21
Department of Surgery, University of Miyazaki, Miyazaki.
22
Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University.
23
Department of Gastroenterology, Iwate Prefectural Central Hospital, Morioka.
24
Department of Gastroenterology, NHO Mie Chuo Medical Center, Tsu.
25
Department of Endoscopy, Nagoya University Hospital, Nagoya.
26
Department of Gastroenterology and Hepatology, National Hospital Organization Fukuoka-higashi Medical Center, Koga.
27
Konankosei Hospital, Konan.
28
Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya.
29
Digestive Disease Center, Kitano Hospital, Osaka.
30
Ina Central Hospital, Ina.

Abstract

OBJECTIVES:

The aim of this study was to assess prevailing treatment of pancreatolithiasis in Japan.

METHODS:

We surveyed clinical data from 1834 patients (1479 men and 355 women) at 125 hospitals.

RESULTS:

Extracorporeal shock-wave lithotripsy (ESWL) was performed alone in 103 patients (5.6%), ESWL plus an endoscopic procedure in 446 (24.3%), endoscopic treatment alone in 261 (14.2%), and surgery in 167 (9.1%). Other treatments were given to 358 (19.5%), whereas 499 (27.2%) received no treatment. Symptoms were relieved in 85.7% after ESWL, 80.8% after endoscopic treatment alone, and 92.8% after surgery. Early complication rates within 3 months after ESWL, endoscopic treatment alone, and surgery were 8%, 4.5%, and 27.1%, respectively. Late complications after ESWL, endoscopic procedures alone, and surgery were 1.7%, 2.5%, and 8.2%, respectively. Symptom relief but also early and late complications were greater after surgery than after ESWL and endoscopic treatment. Among 417 patients undergoing ESWL, 61 (14.6%) required surgery, as did 32 (16%) of 200 patients treated endoscopically. Surgery was required less frequently following initial operative treatment (11/164 patients [6.7%]). Nonsurgical initial treatments were chosen more frequently.

CONCLUSIONS:

First-line treatment of pancreatolithiasis should be ESWL with or without endoscopy because of minimal invasiveness and fewer complications.

PMID:
29851750
DOI:
10.1097/MPA.0000000000001071
[Indexed for MEDLINE]

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