TY - JOUR
T1 - Management of pancreatolithiasis
T2 - A nationwide survey in Japan
AU - Inui, Kazuo
AU - Masamune, Atsushi
AU - Igarashi, Yoshinori
AU - Ohara, Hirotaka
AU - Tazuma, Susumu
AU - Sugiyama, Masanori
AU - Suzuki, Yutaka
AU - Miyoshi, Hironao
AU - Yamamoto, Satoshi
AU - Takeyama, Yoshifumi
AU - Nakano, Eriko
AU - Takuma, Kensuke
AU - Sakagami, Junichi
AU - Hayashi, Kazuki
AU - Kogure, Atsuko
AU - Ito, Tetsuya
AU - Mukai, Tsuyoshi
AU - Maetani, Iruru
AU - Nagahama, Masatsugu
AU - Serikawa, Masahiro
AU - Ueki, Toshiharu
AU - Furuya, Ken
AU - Isayama, Hiroyuki
AU - Moriyama, Ichiro
AU - Shigeno, Masaya
AU - Mizukami, Kazuhiro
AU - Nanashima, Atsushi
AU - Oana, Shuhei
AU - Ikehata, Atsushi
AU - Watanabe, Noriko
AU - Hirooka, Yoshiki
AU - Ogoshi, Keiichiro
AU - Sasaki, Yoji
AU - Iwata, Yoshinori
AU - Kudo, Yasushi
AU - Nakayama, Ataru
AU - Nakamura, Masafumi
N1 - Funding Information:
Izumo; ¶¶¶The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki; ###Department of Gastroenterology, Oita University, Yufu; ****Department of Surgery, University of Miyazaki, Miyazaki; ††††Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University; and ‡‡‡‡Department of Gastroenterology, Iwate Prefectural Central Hospital, Morioka; §§§§Department of Gastroenterology, NHO Mie Chuo Medical Center, Tsu; ||||||||Department of Endoscopy, Nagoya University Hospital, Nagoya; ¶¶¶¶Department of Gastroenterology and Hepatology, National Hospital Organization Fukuoka-higashi Medical Center, Koga; ####Konankosei Hospital, Konan; *****Division of Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya; †††††Digestive Disease Center, Kitano Hospital, Osaka; ‡‡‡‡‡Ina Central Hospital, Ina; Departments of §§§§§Surgery and ||||||||||Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Received for publication November 12, 2017; accepted April 13, 2018. Address correspondence to: Kazuo Inui, MD, PhD, Department of Gastroenterology, Second Teaching Hospital, Fujita Health University School of Medicine, 3-6-10, Otobashi, Nakagawa-ku, Nagoya 454-8509, Japan (e‐mail: kinui@fujita-hu.ac.jp). This study was supported by the grant-in-aid for the Intractable Pancreatic Diseases, supported by the Ministry of Health, Labor, and Welfare of Japan. The authors declare no conflict of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MPA.0000000000001071
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - 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.
AB - 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.
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U2 - 10.1097/MPA.0000000000001071
DO - 10.1097/MPA.0000000000001071
M3 - Review article
C2 - 29851750
AN - SCOPUS:85049033612
SN - 0885-3177
VL - 47
SP - 708
EP - 714
JO - Pancreas
JF - Pancreas
IS - 6
ER -
