Management of Pancreatolithiasis: A Nationwide Survey in Japan.

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.

• Authors: Kazuo Inui, Atsushi Masamune, Yoshinori Igarashi, Hirotaka Ohara, Susumu Tazuma, Masanori Sugiyama, Yutaka Suzuki, Hironao Miyoshi, Satoshi Yamamoto, Yoshifumi Takeyama, Eriko Nakano, Kensuke Takuma, Junichi Sakagami, Kazuki Hayashi, Atsuko Kogure, Tetsuya Ito, Tsuyoshi Mukai, Iruru Maetani, Masatsugu Nagahama, Masahiro Serikawa, Toshiharu Ueki, Ken Furuya, Hiroyuki Isayama, Ichiro Moriyama, Masaya Shigeno, Kazuhiro Mizukami, Atsushi Nanashima, Shuhei Oana, Atsushi Ikehata, Noriko Watanabe, Yoshiki Hirooka, Keiichiro Ogoshi, Yoji Sasaki, Yoshinori Iwata, Yasushi Kudo, Ataru Nakayama, Masafumi Nakamura
• Journal: Pancreas (Pancreas) Vol. 47 Issue 6 Pg. 708-714 (07 2018) ISSN: 1536-4828 [Electronic] United States
• PMID: 29851750 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Asian People
• Child
• Combined Modality Therapy
• Endoscopy (methods)
• Female
• Health Surveys (methods, statistics & numerical data)
• Humans
• Japan
• Lithiasis (ethnology, surgery, therapy)
• Lithotripsy (methods)
• Male
• Middle Aged
• Pancreatic Diseases (ethnology, surgery, therapy)
• Treatment Outcome
• Young Adult