A Predictive Strategy for Nonsurgical Management of Pancreatic Stones.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-04-01 Epub Date: 2024-02-12 DOI:10.1097/MPA.0000000000002310

Satoshi Yamamoto, Kazuo Inui, Yoshiaki Katano, Hironao Miyoshi, Takashi Kobayashi, Yoshihiko Tachi

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Abstract

Objectives: We set out to predict whether nonsurgical treatment is likely to succeed in removing pancreatic stones in a given patient and also to determine an optimal maximal number of extracorporeal shock wave lithotripsy (ESWL) sessions for treatment of pancreatolithiasis in that patient.

Materials and methods: We ascertained the number of ESWL sessions for each of 164 patients undergoing that treatment for pancreatolithiasis between 1992 and 2020. Median follow-up duration was 31 months (range, 0-239), median age was 58 years (22-83), and the male to female ratio was 5.1:1.0. Patients were divided into 2 groups based upon an optimal maximal number of ESWL sessions determined by receiver operating characteristic analysis.

Results: Total stone clearance was achieved in 130 of 164 patients (79%). The median number of ESWL sessions was 3 (1-61). Receiver operating characteristic analysis determined 7 to be the optimal maximal number of sessions. Complete clearance was more frequent (87%) among the 131 patients requiring 7 or fewer ESWL sessions than among the 33 undergoing more (48%, P < 0.001). Seventeen patients (52%) undergoing 8 or more sessions still had residual stones.

Conclusions: If any pancreatic stones persist after 7 ESWL sessions, we recommend transition to medical or surgical treatments.

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非手术治疗胰腺结石的预测策略

研究目的我们旨在预测非手术治疗是否有可能成功清除特定患者的胰腺结石，同时确定体外冲击波碎石术（ESWL）治疗该患者胰腺结石的最佳次数：我们确定了 1992 年至 2020 年间接受 ESWL 治疗的 164 名胰腺结石患者每人的 ESWL 治疗次数。中位随访时间为 31 个月（0-239），中位年龄为 58 岁（22-83），男女比例为 5.1:1.0。根据接收器操作特征分析确定的最佳 ESWL 治疗次数，将患者分为两组：164例患者中有130例（79%）实现了结石完全清除。ESWL 治疗次数的中位数为 3 次（1-61 次）。接收器操作特征分析确定 7 次为最佳的最大治疗次数。在需要 7 次或更少 ESWL 治疗的 131 位患者中，完全清除的比例（87%）高于 33 位接受更多治疗的患者（48%，P < 0.001）。接受8次或8次以上治疗的17名患者（52%）仍有结石残留：结论：如果任何胰腺结石在接受 7 次 ESWL 治疗后仍然存在，我们建议转为药物或手术治疗。

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

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.