Complete clearance of painless pancreatic stones with endotherapy prevents the progression of pancreatic parenchyma atrophy in patients with chronic pancreatitis: Multicenter cohort study

IF 5 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive Endoscopy Pub Date : 2025-02-27 DOI:10.1111/den.14998

Tsukasa Ikeura, Ayaka Takaori, Kazuhiro Kikuta, Ken Ito, Tetsuya Takikawa, Takaaki Eguchi, Tadahisa Inoue, Yasuki Hori, Kenji Nakamura, Mamoru Takenaka, Yoshio Sogame, Tadayuki Takagi, Nao Fujimori, Satoshi Yamamoto, Akira Nakamura, Toshitaka Sakai, Arata Sakai, Takashi Tamura, Tomotaka Saito, Koichi Fujita, Atsushi Kanno, Kunihiro Hosono, Keisuke Iwata, Atsushi Irisawa, Kazuhisa Okamoto, Masaki Kuwatani, Makoto Naganuma, Atsushi Masamune, Yoshifumi Takeyama, Japan Pancreatitis Study Group for CP

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引用次数: 0

Abstract

Objectives

This retrospective multicenter study aimed to clarify the clinical impact of endotherapy for painless pancreatic duct (PD) stones compared with that in patients who received conservative treatment without endotherapy.

Methods

We enrolled 268 patients suffering from chronic pancreatitis with painless PD stones (145 with endotherapy and 123 without endotherapy) and evaluated the impact of endotherapy for painless PD stones on clinical and radiological outcomes.

Results

When conservative treatment without endotherapy was set as a reference, complete clearance of the targeted PD stones decreased the relative risk for atrophy of pancreatic parenchyma after inclusion (hazard ratio [HR] 0.42; 95% confidence interval [CI] 0.21–0.84). Incomplete clearance of the targeted PD stones was identified as a risk factor for new-onset or worsening of diabetes (HR 2.08; 95% CI 1.10–3.91) and inducement of pain attack (HR 4.03; 95% CI 1.45–11.19), although complete clearance was not correlated with these outcomes.

Conclusion

In chronic pancreatitis patients with painless PD stones, endotherapy with complete stone clearance allows the maintenance of pancreatic parenchymal volume. However, if complete clearance fails, endotherapy could lead to aggravation of glucose tolerance and pain attacks during follow-up.

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内镜治疗完全清除无痛胰腺结石可防止慢性胰腺炎患者胰腺实质萎缩进展：多中心队列研究

目的：本回顾性多中心研究旨在阐明内镜治疗对无痛胰管结石患者的临床影响，并与不接受内镜治疗的保守治疗患者进行比较。方法：我们招募了268例慢性胰腺炎合并无痛性PD结石患者（145例接受内镜治疗，123例未接受内镜治疗），评估内镜治疗对无痛性PD结石的临床和影像学结果的影响。结果：以保守治疗不进行内治疗为参照，完全清除靶PD结石可降低纳入后胰腺实质萎缩的相对风险(风险比[HR] 0.42；95%可信区间[CI] 0.21-0.84)。靶向PD结石的不完全清除被确定为糖尿病新发或恶化的危险因素(HR 2.08；95% CI 1.10-3.91)和疼痛发作诱因(HR 4.03；95% CI 1.45-11.19)，尽管完全清除率与这些结果无关。结论：慢性胰腺炎伴无痛性PD结石的患者，采用完全清除结石的内镜治疗可维持胰腺实质体积。然而，如果完全清除失败，在随访期间，内皮治疗可能导致糖耐量加重和疼痛发作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Endoscopy 医学-外科

CiteScore

10.10

自引率

15.10%

发文量

291

审稿时长

6-12 weeks

期刊介绍： Digestive Endoscopy (DEN) is the official journal of the Japan Gastroenterological Endoscopy Society, the Asian Pacific Society for Digestive Endoscopy and the World Endoscopy Organization. Digestive Endoscopy serves as a medium for presenting original articles that offer significant contributions to knowledge in the broad field of endoscopy. The Journal also includes Reviews, Original Articles, How I Do It, Case Reports (only of exceptional interest and novelty are accepted), Letters, Techniques and Images, abstracts and news items that may be of interest to endoscopists.