Related Experiment Videos
Management for pancreatolithiasis: a Japanese multicenter study.
Yutaka Suzuki1, Masanori Sugiyama, Kazuo Inui
1Japanese Study Group for Pancreato-Biliary Lithiasis, Japan. ysuzuki@ks.kyorin-u.ac.jp
Pancreas
|April 6, 2013
Summary
Extracorporeal shock wave lithotripsy (ESWL) and endoscopy are recommended first-line treatments for pancreatic stones due to minimal invasiveness. Surgery is reserved for cases where these methods fail.
Area of Science:
- Gastroenterology
- Endocrinology
- Surgical Gastroenterology
Background:
- Pancreatolithiasis, or pancreatic stones, presents complex clinical challenges.
- Effective treatment strategies are crucial for managing patient outcomes and preventing recurrence.
Purpose of the Study:
- To investigate the clinical features of pancreatolithiasis.
- To determine optimal treatment strategies for pancreatic stones based on a large multicenter study.
Main Methods:
- A retrospective analysis of 916 patients with pancreatolithiasis across 34 institutions over 5 years.
- Evaluation of treatment outcomes for extracorporeal shock wave lithotripsy (ESWL), surgery, and endoscopy.
Main Results:
- ESWL achieved 92.4% stone fragmentation but only 49.4% complete clearance, lower than endoscopy (87.9%).
- Surgery had a higher early complication rate (13.3%) than ESWL (6.1%).
- Stone recurrence was significantly higher after ESWL (22.5%) and endoscopy (12.0%) compared to surgery (1.5%). Abdominal pain also recurred more frequently after ESWL.
Conclusions:
- ESWL, alone or with endoscopy, is recommended as a first-line treatment for pancreatic stones due to its minimal invasiveness and low complication rates.
- Surgical intervention should be reserved for patients who do not respond to ESWL or endoscopic treatments.
- Recurrence of stones and pain is common within 3 years for ESWL and endoscopic treatments.
Related Concept Videos
01:29Chronic Pancreatitis II: Collaborative Care
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
01:30Acute Pancreatitis II: Clinical Manifestations and Management
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
01:30Urinary Tract Calculi III: Medical Management
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
01:25Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
01:28Urinary Tract Calculi V: Nursing Management
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...