Management of Pancreatic Calculi: An Update
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Pancreatolithiasis, or pancreatic calculi (PC), is a sequel of chronic pancreatitis (CP) and may occur in the main ducts, side branches or parenchyma. Calculi are the end result, irrespective of the etiology of CP. PC contains an inner nidus surrounded by successive layers of calcium carbonate. These calculi obstruct the pancreatic ducts and produce ductal hypertension, which leads to pain, the cardinal feature of CP. Both endoscopic therapy and surgery aim to clear these calculi and decrease ductal hypertension. In small PC, endoscopic retrograde cholangiopancreatography (ERCP) followed by sphincterotomy and extraction is the treatment of choice. Large calculi require fragmentation by extracorporeal shock wave lithotripsy (ESWL) prior to their extraction or spontaneous expulsion. In properly selected cases, ESWL followed by ERCP is the standard of care for the management of large PC. Long-term outcomes following ESWL have demonstrated good pain relief in approximately 60% of patients. However, ESWL has limitations. Per oral pancreatoscopy and intraductal lithotripsy represent techniques in evolution, and in current practice their use is limited to centers with considerable expertise. Surgery should be offered to all patients with extensive PC, associated multiple ductal strictures or following failed endotherapy.
Abstract
Pancreatolithiasis, or pancreatic calculi (PC), is a sequel of chronic pancreatitis (CP) and may occur in the main ducts, side branches or parenchyma. Calculi are the end result, irrespective of the etiology of CP. PC contains an inner nidus surrounded by successive layers of calcium carbonate. These calculi obstruct the pancreatic ducts and produce ductal hypertension, which leads to pain, the cardinal feature of CP. Both endoscopic therapy and surgery aim to clear these calculi and decrease ductal hypertension. In small PC, endoscopic retrograde cholangiopancreatography (ERCP) followed by sphincterotomy and extraction is the treatment of choice. Large calculi require fragmentation by extracorporeal shock wave lithotripsy (ESWL) prior to their extraction or spontaneous expulsion. In properly selected cases, ESWL followed by ERCP is the standard of care for the management of large PC. Long-term outcomes following ESWL have demonstrated good pain relief in approximately 60% of patients. However, ESWL has limitations. Per oral pancreatoscopy and intraductal lithotripsy represent techniques in evolution, and in current practice their use is limited to centers with considerable expertise. Surgery should be offered to all patients with extensive PC, associated multiple ductal strictures or following failed endotherapy.
참고문헌 (52)
- Lankisch PG, "Pancreatitis" (1998), Springer-Verlag
- Tandan M, "Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi: a large single center experience", Indian J Gastroenterol, 29, pp.143~148 (2010)
- Bhasin DK, "Clinical profile of idiopathic chronic pancreatitis in North India", Clin Gastroenterol Hepatol, 7, pp.594~599 (2009)
- Balakrishnan V, "Chronic pancreatitis:a prospective nationwide study of 1,086 subjects from India", JOP, 9, pp.593~600 (2008)
- Rösch T, "Endoscopic treatment of chronic pancreatitis: a multicenter study of 1000 patients with longterm follow-up", Endoscopy, 34, pp.765~771 (2002)
- Ong WC, "Multiple main pancreatic duct stones in tropical pancreatitis: safe clearance with extracorporeal shockwave lithotripsy", J Gastroenterol Hepatol, 21, pp.1514~1518 (2006)
- Chari S, "Radiological appearance of pancreatic calculi in tropical versus alcoholic chronic pancreatitis", J Gastroenterol Hepatol, 7, pp.42~44 (1992)
- Jin CX, "Pancreatic stone protein of pancreatic calculi in chronic calcified pancreatitis in man", JOP, 3, pp.54~61 (2002)
- Pitchumoni CS, "Ultrastructure and elemental composition of human pancreatic calculi", Pancreas, 2, pp.152~158 (1987)
- Lehman GA, "Role of ERCP and other endoscopic modalities in chronic pancreatitis", Gastrointest Endosc, 56(6), pp.S237~S240 (2002)
- Dumonceau JM, "Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline", Endoscopy, 44, pp.784~800 (2012)
- Farnbacher MJ, "Pancreatic duct stones in chronic pancreatitis:criteria for treatment intensity and success", Gastrointest Endosc, 56, pp.501~506 (2002)
- Thomas M, "Mechanical lithotripsy of pancreatic and biliary stones: complications and available treatment options collected from expert centers", Am J Gastroenterol, 102, pp.1896~1902 (2007)
- Chaussy C, "First clinical experience with extracorporeally induced destruction of kidney stones by shock waves", J Urol, 127, pp.417~420 (1982)
- Sauerbruch T, "Fragmentation of bile duct stones by extracorporeal shock waves: a new approach to biliary calculi after failure of routine endoscopic measures", Gastroenterology, 96, pp.146~152 (1989)
- Neuhaus H, "Fragmentation of pancreatic stones by extracorporeal shock wave lithotripsy", Endoscopy, 23, pp.161~165 (1991)
- Delhaye M, "Extracorporeal shock-wave lithotripsy of pancreatic calculi", Gastroenterology, 102, pp.610~620 (1992)
- Dumonceau JM, "Endoscopic pancreatic drainage in chronic pancreatitis associated with ductal stones:long-term results", Gastrointest Endosc, 43, pp.547~555 (1996)
- Costamagna G, "Extracorporeal shock wave lithotripsy of pancreatic stones in chronic pancreatitis:immediate and medium-term results", Gastrointest Endosc, 46, pp.231~236 (1997)
- Kozarek RA, "Clinical outcomes in patients who undergo extracorporeal shock wave lithotripsy for chronic calcific pancreatitis", Gastrointest Endosc, 56, pp.496~500 (2002)
- Schneider HT, "Piezoelectric shock wave lithotripsy of pancreatic duct stones", Am J Gastroenterol, 89, pp.2042~2048 (1994)
- Ohara H, "Single application extracorporeal shock wave lithotripsy is the first choice for patients with pancreatic duct stones", Am J Gastroenterol, 91, pp.1388~1394 (1996)
- Inui K, "Treatment of pancreatic stones with extracorporeal shock wave lithotripsy: results of a multicenter survey", Pancreas, 30, pp.26~30 (2005)
- Delhaye M, "Endoscopic therapy for chronic pancreatitis", Scand J Surg, 94, pp.143~153 (2005)
- "Extracorporeal shockwave lithotripsy" (2006)[URL]
- Tandan M, "Extracorporeal shock wave lithotripsy for pancreatic and large common bile duct stones", World J Gastroenterol, 17, pp.4365~4371 (2011)
- Darisetty S, "Epidural anesthesia is effective for extracorporeal shock wave lithotripsy of pancreatic and biliary calculi", World J Gastrointest Surg, 2, pp.165~168 (2010)
- Milovic V, "Extracorporeal shock wave lithotripsy with a transportable mini-lithotripter and subsequent endoscopic treatment improves clinical outcome in obstructive calcific chronic pancreatitis", Gastrointest Endosc, 74, pp.1294~1299 (2011)
- Choi EK, "Use of intravenous secretin during extracorporeal shock wave lithotripsy to facilitate endoscopic clearance of pancreatic duct stones", Pancreatology, 12, pp.272~275 (2012)
- Tandan M, "ESWL of large pancreatic calculi: a decades experience", United European Gastroenterol J, 2(1), pp.A7~ (2014)
- Guda NM, "Extracorporeal shock wave lithotripsy in the management of chronic calcific pancreatitis: a meta-analysis", JOP, 6, pp.6~12 (2005)
- Nguyen-Tang T, "Endoscopic treatment in chronic pancreatitis, timing, duration and type of intervention", Best Pract Res Clin Gastroenterol, 24, pp.281~298 (2010)
- Adamek HE, "Long term follow up of patients with chronic pancreatitis and pancreatic stones treated with extracorporeal shock wave lithotripsy", Gut, 45, pp.402~405 (1999)
- Delhaye M, "Longterm clinical outcome after endoscopic pancreatic ductal drainage for patients with painful chronic pancreatitis", Clin Gastroenterol Hepatol, 2, pp.1096~1106 (2004)
- Seven G, "Long-term outcomes associated with pancreatic extracorporeal shock wave lithotripsy for chronic calcific pancreatitis", Gastrointest Endosc, 75(e1), pp.997~1004 (2012)
- Tandan M, "Long-term clinical outcomes of extracorporeal shockwave lithotripsy in painful chronic calcific pancreatitis", Gastrointest Endosc, 78, pp.726~733 (2013)
- Li BR, "Risk factors for complications of pancreatic extracorporeal shock wave lithotripsy", Endoscopy, 46, pp.1092~1100 (2014)
- Hirata N, "Hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones", J Gastroenterol, 34, pp.713~716 (1999)
- Leifsson BG, "Splenic rupture following ESWL for a pancreatic duct calculus", Dig Surg, 18, pp.229~230 (2001)
- Plaisier PW, "Splenic abscess after lithotripsy of pancreatic duct stones", Dig Surg, 18, pp.231~232 (2001)
- Karakayali F, "Acute necrotizing pancreatitis as a rare complication of extracorporeal shock wave lithotripsy", Int J Urol, 13, pp.613~615 (2006)
- Ohyama H, "Efficacy of stone density on noncontrast computed tomography in predicting the outcome of extracorporeal shock wave lithotripsy for patients with pancreatic stones", Pancreas, 44, pp.422~428 (2015)
- Dumonceau JM, "Treatment for painful calcified chronic pancreatitis: extracorporeal shock wave lithotripsy versus endoscopic treatment: a randomised controlled trial", Gut, 56, pp.545~552 (2007)
- Howell DA, "Endoscopic treatment of pancreatic duct stones using a 10F pancreatoscope and electrohydraulic lithotripsy", Gastrointest Endosc, 50, pp.829~833 (1999)
- Attwell AR, "Endoscopic retrograde cholangiopancreatography with per oral pancreatoscopy for calcific chronic pancreatitis using endoscope and catheter-based pancreatoscopes: a 10-year single-center experience", Pancreas, 43, pp.268~274 (2014)
- Attwell AR, "ERCP with per-oral pancreatoscopy-guided laser lithotripsy for calcific chronic pancreatitis: a multicenter U.S. experience", Gastrointest Endosc, 82, pp.311~318 (2015)
- Noda A, "Trimethadione (troxidone)dissolves pancreatic stones", Lancet, 2, pp.351~353 (1984)
- Díte P, "A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis", Endoscopy, 35, pp.553~558 (2003)
- Cahen DL, "Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis", N Engl J Med, 356, pp.676~684 (2007)
- Rutter K, "Hospitalization, frequency of interventions, and quality of life after endoscopic, surgical, or conservative treatment in patients with chronic pancreatitis", World J Surg, 34, pp.2642~2647 (2010)
- Cahen DL, "Long-term outcomes of endoscopic vs surgical drainage of the pancreatic duct in patients with chronic pancreatitis", Gastroenterology, 141, pp.1690~1695 (2011)
- Tandan M, "Endotherapy in chronic pancreatitis", World J Gastroenterol, 19, pp.6156~6164 (2013)
