Endoscopic Retrograde Cholangiopancreatography With Per Oral Pancreatoscopy for Calcific Chronic Pancreatitis Using Endoscope and Catheter-Based Pancreatoscopes A 10-Year Single-Center Experience
Endoscopic Retrograde Cholangiopancreatography With Per Oral Pancreatoscopy for Calcific Chronic Pancreatitis Using Endoscope and Catheter-Based Pancreatoscopes A 10-Year Single-Center Experience
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DOI：
10.1097/mpa.0b013e3182965d81
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发表时间：
2014-03-01
期刊：
影响因子：
2.9
通讯作者：
Shah, Raj J.
中科院分区：
文献类型：
--
作者：
Attwell, Augustin R.;Brauer, Brian C.;Shah, Raj J.
目的：经口胰镜（POP）联合电液碎石术（EHL）或激光碎石术（LL）可在内镜逆行胰胆管造影中实现结石碎裂和清除。我们的研究评估了POP治疗主胰管结石的安全性和有效性。方法：本研究是一项队列研究，研究对象为2000年1月至2011年3月期间因PD结石接受POP治疗的EHL/LL患者。技术成功定义为完全或部分结石清除，临床成功定义为阿片类药物使用、疼痛或住院治疗减少50%以上。结果46例PD结石患者采用10F胆道镜（POP- endo） （n = 31）或导管系统（POP- cath, n = 15）行POP治疗。46例患者中39例（85%）行电液碎石术。46例患者中有7例（15%）进行了无EHL或LL的结石取出。31例患者中，POP-Endo和POP-Cath的技术成功率分别为27例（87%）和15例（100%）（P = 0.29）。31例患者中有21例（68%）获得完全清除，15例患者中有11例（73%）获得完全清除（P = 0.519）。经口胰镜相关并发症发生率为10%。46例患者中有43例（93%）的随访时间中位数为18个月（范围1-60个月）。总体临床成功率为74%。结论口服胰镜引导下的内镜治疗可部分或完全清除PD结石。在大多数患者中，POP-Endo与POP-Cath系统之间的技术成功率似乎相似，并且与临床改善有关。
ObjectivesPer oral pancreatoscopy (POP) with electrohydraulic lithotripsy (EHL) or laser lithotripsy (LL) permits stone fragmentation and removal during endoscopic retrograde cholangiopancreatography. Our study evaluates the safety and efficacy of POP in patients with main pancreatic duct (PD) stones.MethodsThis was a cohort study of patients undergoing POP with EHL/LL for PD stones between January 2000 and March 2011. Technical success was defined as complete or partial stone clearance, and clinical success as greater than 50% reduction in opiate use, pain, or hospitalizations.ResultsForty-six patients underwent POP for PD stones using a 10F cholangioscope (POP-Endo) (n = 31) or catheter-based system (POP-Cath, n = 15). Electrohydraulic lithotripsy/LL was performed in 39 (85%) of 46 patients. Stone extraction without EHL or LL was performed in 7 (15%) of 46 patients. Technical success for POP-Endo versus POP-Cath was 27 (87%) of 31 versus 15 (100%) of 15 patients (P = 0.29). Complete clearance was achieved in 21 (68%) of 31 versus 11 (73%) of 15 patients, respectively (P = 0.519). Per oral pancreatoscopy-related complications were found in 10%. Follow-up in 43 (93%) of 46 patients was a median of 18 months (range, 1-60 months). Overall clinical success was 74%.ConclusionsPer oral pancreatoscopy-guided endotherapy leads to partial or complete stone clearance in most patients with PD stones. The technical success rates between POP-Endo versus POP-Cath systems appear similar and are associated with clinical improvement in most patients.