Long-Term Efficacy and Safety of Digital-Single-Operator-Video-Pancreatoscopy Guided Lithotripsy for Pancreatic Duct Stones.

IF 5.8 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

United European Gastroenterology Journal Pub Date : 2025-06-06 DOI:10.1002/ueg2.70063

Claudio C Conrad, Mark Ellrichmann, Michiel Bronswijk, Schalk van der Merwe, Tobias Dertmann, Hadil Layka, Radhika Chavan, Sanjay Rajput, Pieter Jan de Jonge, Peter D Siersema, Marianne Udd, Leena Kylanpaa, Philip Grunert, Gilbert Rahe, Christoph Schramm, Jassin Rashidi-Alavijeh, Marco J Bruno, Torsten Beyna, Christian Gerges

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引用次数: 0

Abstract

Introduction: Ductal decompression has become the main approach for treating patients with symptomatic chronic calcifying pancreatitis and signs of ductal hypertension. Digital single operator video pancreatoscopy (dSOVP) has shown high success rates when compared with more established techniques such as extracorporeal shock wave lithotripsy. However, there is still limited evidence on long-term clinical success and quality of life.

Methods: Patients with chronic calcifying pancreatitis who underwent digital single operator video pancreatoscopy guided electrohydraulic lithotripsy (EHL) of pancreatic duct stones with initial technical and clinical success were recruited for this retrospective, multicenter cohort study. Persistence of clinical success (defined as pain reduction > 50% in numerical rating scale [NRS]) as well as postinterventional quality of life (QOL) were retrospectively evaluated by database analysis and with QOL using the Mental and Physical Condition Scores (MCS, PCS).

Results: A total of 58 patients were included in the long-term follow-up conducted over 24 months. Significant and sustained pain relief was reported in 70.7% of patients (n = 41) at month 3; this effect persisted until month 24. MCS decreased from 50.36 ± 13.3 at baseline to 49.75 ± 11.1 at month 12 with no statistically significant difference (data available for 42 patients, p = 0.15). Similarly, the PCS showed no significant improvement, remaining constant at 44.9 ± 9.8 at baseline and 44.9 ± 10.8 at month 12 (p = 0.1). The overall adverse event rate was 26% (11 patients), primarily consisting of mild to moderate pancreatitis (n = 9, 22%).

Conclusions: Digital single operator video pancreatoscopy guided lithotripsy was shown to be safe and effective in a long-term follow-up regarding pain control but had no significant influence on QOL. Complete stone removal seems to be the key point for long-term clinical success.

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数字-单人内镜下胰管镜导碎石治疗胰管结石的远期疗效和安全性。

导管减压已成为治疗有症状性慢性钙化性胰腺炎和导管高血压征象的主要方法。数字单操作员视频胰镜（dSOVP）与更成熟的技术（如体外冲击波碎石术）相比，显示出更高的成功率。然而，关于长期临床成功和生活质量的证据仍然有限。方法：慢性钙化性胰腺炎患者接受数字视频胰镜引导下的胰管结石电液碎石术（EHL），初步技术和临床成功，纳入本回顾性多中心队列研究。通过数据库分析和使用精神和身体状况评分（MCS， PCS）回顾性评估临床成功的持久性（在数值评定量表[NRS]中定义为疼痛减轻bbb50 %）以及介入后生活质量（QOL）。结果：共纳入58例患者，随访时间超过24个月。在第3个月，70.7%的患者（n = 41）报告了显著和持续的疼痛缓解；这种影响一直持续到第24个月。MCS从基线时的50.36±13.3降至第12个月时的49.75±11.1，差异无统计学意义（42例患者数据，p = 0.15）。同样，PCS也没有明显改善，维持在基线时的44.9±9.8和第12个月时的44.9±10.8 （p = 0.1）。总体不良事件发生率为26%（11例），主要包括轻度至中度胰腺炎（n = 9, 22%）。结论：数字视频胰镜引导碎石在长期随访中对疼痛的控制是安全有效的，但对生活质量没有显著影响。完全去除结石似乎是长期临床成功的关键。

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

United European Gastroenterology Journal GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

10.50

自引率

13.30%

发文量

147

期刊介绍： United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.