Management of Pancreatolithiasis: A Nationwide Survey in Japan. Issue 6 (July 2018)

• Record Type: Journal Article
• Authors: Inui, Kazuo; Masamune, Atsushi; Igarashi, Yoshinori; Ohara, Hirotaka; Tazuma, Susumu; Sugiyama, Masanori; Suzuki, Yutaka; Miyoshi, Hironao; Yamamoto, Satoshi; Takeyama, Yoshifumi; Nakano, Eriko; Takuma, Kensuke; Sakagami, Junichi; Hayashi, Kazuki; Kogure, Atsuko; Ito, Tetsuya; Mukai, Tsuyoshi; Maetani, Iruru; Nagahama, Masatsugu; Serikawa, Masahiro; Ueki, Toshiharu; Furuya, Ken; Isayama, Hiroyuki; Moriyama, Ichiro; Shigeno, Masaya; Mizukami, Kazuhiro; Nanashima, Atsushi; Oana, Shuhei; Ikehata, Atsushi; Watanabe, Noriko; Hirooka, Yoshiki; Ogoshi, Keiichiro; Sasaki, Yoji; Iwata, Yoshinori; Kudo, Yasushi; Nakayama, Ataru; Nakamura, Masafumi;
• Is Part Of: Pancreas. Volume 47:Issue 6(2018)
• Publication Date: 2018-07
• Subjects: chronic pancreatitis -- endoscopic pancreatic sphincterotomy -- endoscopic removal of pancreatic stones -- extracorporeal shock-wave lithotripsy -- pancreatic ductal decompression surgery; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001071
• Languages: English
• ISSNs: 0885-3177

Abstract

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.