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Endoscopic Treatment of Pancreatic Calculi

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초록

Chronic pancreatitis is a progressive inflammatory disease that destroys pancreatic parenchyma and alters ductal stricture, leading to ductaldestruction and abdominal pain. Pancreatic duct stones (PDSs) are a common complication of chronic pancreatitis that requires treatmentto relieve abdominal pain and improve pancreas function. Endoscopic therapy, extracorporeal shock wave lithotripsy (ESWL), andsurgery are treatment modalities of PDSs, although lingering controversies have hindered a consensus recommendation. Many comparativestudies have reported that surgery is the superior treatment because of reduced duration and frequency of hospitalization, cost, painrelief, and reintervention, while endoscopic therapy is effective and less invasive but cannot be used in all patients. Surgery is the treatmentof choice when endoscopic therapy has failed, malignancy is suspected, or duodenal stricture is present. However, in patients with the appropriateindications or at high-risk for surgery, endoscopic therapy in combination with ESWL can be considered a first-line treatment. We expect that the development of advanced endoscopic techniques and equipment will expand the role of endoscopic treatment inPDS removal.

Abstract

Chronic pancreatitis is a progressive inflammatory disease that destroys pancreatic parenchyma and alters ductal stricture, leading to ductaldestruction and abdominal pain. Pancreatic duct stones (PDSs) are a common complication of chronic pancreatitis that requires treatmentto relieve abdominal pain and improve pancreas function. Endoscopic therapy, extracorporeal shock wave lithotripsy (ESWL), andsurgery are treatment modalities of PDSs, although lingering controversies have hindered a consensus recommendation. Many comparativestudies have reported that surgery is the superior treatment because of reduced duration and frequency of hospitalization, cost, painrelief, and reintervention, while endoscopic therapy is effective and less invasive but cannot be used in all patients. Surgery is the treatmentof choice when endoscopic therapy has failed, malignancy is suspected, or duodenal stricture is present. However, in patients with the appropriateindications or at high-risk for surgery, endoscopic therapy in combination with ESWL can be considered a first-line treatment. We expect that the development of advanced endoscopic techniques and equipment will expand the role of endoscopic treatment inPDS removal.

참고문헌 (61)

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