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EFFECT OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY AND ENDOSCOPIC TREATMENT ON SYMPTOMS AND PANCREATIC FUNCTION IN PANCREATOLITHIASIS
Author(s) -
Tada Tomoko,
Ukita Takeo,
Maetani Iruru,
Sakai Yoshihiro,
Igarashi Yoshinori
Publication year - 2006
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2006.00564.x
Subject(s) - medicine , pancreatic duct , pancreatitis , endoscopic treatment , extracorporeal shock wave lithotripsy , surgery , exacerbation , acute pancreatitis , octreotide , lithotripsy , gastroenterology , endoscopy , somatostatin
Aims: To investigate the efficacy of extracorporeal shockwave lithotripsy (ESWL) combined with endoscopic treatment for pancreatolithiasis and assess the pancreatic functions after treatment. Patients: Forty‐eight cases with pancreatolithiasis in the main pancreatic duct (MPD) treated by ESWL combined with endoscopic treatments were investigated. Methods: The disappearance rate of abdominal symptoms, the frequency of admission for acute exacerbation of pancreatitis before and after treatment, the relationship of removal of pancreatic stones with recurrence and stricture of the MPD, and pancreatic functions before and after treatment were examined. Results: Treatment for pancreatolithiasis improved symptoms in 95.1% and significantly reduced the frequency of admission for 1 year from 1.4 to 0.2 on average. Pancreatic stones were excellently eliminated in 93.8%. Even in cases complicated with the stricture of MPD, combination with endoscopic techniques provided treatment efficacy comparable to that in cases without such complications. The Bentiromide test significantly improved within 3 months after treatment. It improved 1–2 and 2–3 years after treatment but there was no significant difference. Endocrine functions were maintained in 93.6%, 74.3%, 66.7%, and 64.3% within 3 months, 1–2 years, 2–3 years, and 3 or more years, respectively, after treatment. Conclusions: ESWL combined with endoscopic treatment provides comparable treatment efficacy in cases with and without stricture of the MPD. Treatment for pancreatolithiasis is useful for not only alleviating abdominal symptoms but also maintaining pancreatic exocrine function and management of the diabetes.