Management for pancreatolithiasis-A Japanese multicenter study

Suzuki, Yutaka; Sugiyama, Masanori; INUI, Kazuo; Igarashi, Yoshinori; Ohara, Hirotaka; Tazuma, Susumu; TSUJI, Tadao; MIYAGAWA, Hiroyuki; ATOMI, Yutaka

doi:10.2958/suizo.24.25

Cited by 20 publications

(32 citation statements)

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“…Conventional endoscopy for the removal of obstructive PD stones with sphincterotomy and basket or balloon extraction, allows for stone extraction in a minority of patients. Conventional endoscopy is regularly limited by factors such as stone size, stone location, and previous gastric surgery [29,36]. In addition, stone extraction may not be possible if the stone is embedded in the ductal system or when strictures are present [37].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, stone extraction may not be possible if the stone is embedded in the ductal system or when strictures are present [37]. Two retrospective studies reported a 9 % ductal clearance rate after conventional endoscopy in 1041 patients with chronic pancreatitis [27,29], whereas a survey of 125 hospitals reported a 14 % ductal clearance rate in 1834 patients with chronic pancreatitis [38].…”

Section: Discussionmentioning

confidence: 99%

“…Factors associated with more ESWL sessions required for complete stone fragmentation are larger stones [40], multiple stones [41] or stones associated with main pancreatic duct strictures [24]. Multicenter surveys have suggested that stone fragmentation is less frequently successful in low-volume centers, while the type of lithotripsy has been controversial [29,36,38]. Factors associated with successful ductal clearance after ESWL are solitary stones [19,21,24,42,43], stones located in the pancreatic head [19], stones with lower density at CT scan (< 820.5 HU) [21], pancreatic stenting prior to ESWL [14,44] and pre-ESWL administration of secretin [44].…”

Section: E1081mentioning

confidence: 99%

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Success of extracorporeal shock wave lithotripsy and ERCP in symptomatic pancreatic duct stones: a systematic review and meta-analysis

et al. 2020

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Background and study aims Pain is the most frequent and dominant symptom of chronic pancreatitis. Currently, these patients are treated using a step-up approach, including analgesics and lifestyle adjustments, endoscopic, and eventually surgical treatment. Extracorporeal shock wave lithotripsy (ESWL) is indicated after failure of the first step in patients with symptomatic intraductal stones larger than 5 mm in the head or body of the pancreas. To assess the complete ductal clearance rate and pain relief after ESWL in patients with symptomatic chronic pancreatitis with pancreatic duct stones, a systematic review and meta-analysis was performed. Patients and methods A systematic literature search from January 2000 to December 2018 was performed in PubMed, the Cochrane Library, and EMBASE for studies on ductal clearance rate of ESWL in patients with symptomatic chronic pancreatitis with pancreatic duct stones. Results After screening 486 studies, 22 studies with 3868 patients with chronic pancreatitis undergoing ESWL for pancreatic duct stones were included. The pooled proportion of patients with complete ductal clearance was 69.8 % (95 % CI 63.8–75.5). The pooled proportion of complete absence of pain during follow-up was 64.2 % (95 % CI 57.5–70.6). Complete stone fragmentation was 86.3 % (95 % CI 76.0–94.0). Post-procedural pancreatitis and cholangitis occurred in 4.0 % (95 % CI 2.5–5.8) and 0.5 % (95 % CI 0.2–0.9), respectively. Conclusion Treatment with ESWL results in complete ductal clearance rate in a majority of patients, resulting in absence of pain during follow up in over half of patients with symptomatic chronic pancreatitis caused by obstructing pancreatic duct stones.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: E1081mentioning

confidence: 99%

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Success of extracorporeal shock wave lithotripsy and ERCP in symptomatic pancreatic duct stones: a systematic review and meta-analysis

et al. 2020

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“…665 pancreatic stone were treated medically (endoscopy and/or ESWL) in our hospital these 27 years with stone-free rate 75.2%, pain-free rate 97.1%, and a stone recurrence rate 5.0%. The pain-free rate is relatively high, but the stone-free rete is somewhat low (Table 3) [9,10]. So, as a method to raise this stone-free rate, we started our new treatment via the minor.…”

Section: Results Of the Treatment Via Minor Papaillamentioning

confidence: 99%

Endoscopic treatment of pancreatic diseases via Duodenal Minor Papilla: 135 cases treated by Sphyncterotomy, Endoscopic Pancreatic Duct Balloon Dilation (EPDBD), and Pancreatic Stenting (EPS)

Tsuji¹,

Sun²,

Sugiyama³

et al. 2019

Ann Clin Gastroenterol Hepatol

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Treatments via the minor papilla is effective where the deep cannulation via the major papilla is impossible in such cases as [1] the Wirsung's duct is infl ammatory narrowed, bent or obstructed by impacted stones [2] pancreatic duct divisum (complete or incomplete) [3], maljunction of pancreatico-biliary union with stones [4], pancreatic stones in the Santorini's duct. In [1,2] cases, the pancreatic juice fl ow via the major papilla decreases, while that of the minor papilla increases. Then the size of minor papilla and its orifi ce shows corresponding enlargement. This substitutional mechanism is an advantage when undertaking our new method. Since the pancreatic juice fl ow is maintained via the minor papilla in these cases, accurate and careful endoscopic skills are necessary to prevent pancreatitis due to the occlusion of the Santorini's duct after this procedure. We have experienced 135 cases treated via minor papilla in these 27 years, so we would like to report about its safety and effi cacy.

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“…Selection of the appropriate treatment method for pancreatolithiasis depends on the location, size, and number of stones. [ 11 , 12 ] Operative treatment, ESWL, and endoscopic lithoextraction are main treatments. [ 12 ] Generally, operation is recommended for diffusing PDSs filling ducts and stones exiting the tail of the pancreas.…”

Section: Discussionmentioning

confidence: 99%

Successful endoscopic removal of a rare, large impacted pancreatic duct stone using grasping forceps

et al. 2018

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Management for pancreatolithiasis-A Japanese multicenter study

Cited by 20 publications

References 1 publication

Success of extracorporeal shock wave lithotripsy and ERCP in symptomatic pancreatic duct stones: a systematic review and meta-analysis

Success of extracorporeal shock wave lithotripsy and ERCP in symptomatic pancreatic duct stones: a systematic review and meta-analysis

Endoscopic treatment of pancreatic diseases via Duodenal Minor Papilla: 135 cases treated by Sphyncterotomy, Endoscopic Pancreatic Duct Balloon Dilation (EPDBD), and Pancreatic Stenting (EPS)

Successful endoscopic removal of a rare, large impacted pancreatic duct stone using grasping forceps

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