| 共同演者 |
Igarashi Yoshinori（Division of Gastroenterology and Hepatology, Toho University, Omori Medical Center, Japan）, Mimura Takahiko（Division of Gastroenterology and Hepatology, Toho University, Omori Medical Center, Japan）, Kamata Itaru（Division of Gastroenterology and Hepatology, Toho University, Omori Medical Center, Japan）, Kishimoto Yui（Division of Gastroenterology and Hepatology, Toho University, Omori Medical Center, Japan）, Okano Naoki（Division of Gastroenterology and Hepatology, Toho University, Omori Medical Center, Japan） |
| 抄録 |
Aim：To evaluate the efficacy of the combination of endoscopic lithotomy and Extracorporeal shock wave lithotripsy（ESWL）or electrohydraulic lithotripsy（EHL）for the treatment of pancreatic duct stones. Methods：ESWL was considered in cases with endoscopically unremovable stones. If the ESWL and endoscopic lithotomy combination failed, EHL was performed as a second-line intervention. The Spyglass peroral cholangiopancreatoscopy system has been used for EHL since 2010 in our hospital. Results：A total of 95 patients with chronic calcific pancreatitis underwent endoscopic lithotomy at our center between May 2005 and December 2012. Fragmentation was successful in 65（68.4%）patients. Thirteen（13.6%）patients（5 cases with and 8 cases without an endoscopic pancreatic stent（EPS）or ENPD）received EHL after combination therapy failed. In the group where it was possible to place an EPS or ENPD before ESWL treatment, EHL using the Spyglass scope system was successful in 3（75%）patients；however, it was not successful in any of the 3 patients in whom it was not possible to place the EPS or ENPD. On univariate analysis, negotiating the guidewire through a severe MPD stricture was significantly associated with a higher rate of stone fragmentation（p＜0.05）. Conclusions：EHL using the Spyglass scope system was effective in cases of MPD stricture where an EPS or ENPD could be placed, but further prospective randomized studies are needed. |
