A Comparative Analysis of Effect Between Surgical and Endoscopic Therapy for Chronic Pancreatitis Combined with Pancreatic Ductal Stones_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 GONGYi ,  WANGHuai-zhi

Department of Hepatobiliary Surgery, Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China;

Corresponding author：

WANGHuai-zhi, Email: whuaizhi@gmail.com

Keywords：

Chronic pancreatitis; Pancreatic ductal stones; Surgical therapy; Endoscopic therapy; Effect

DOI：

10.7507/1007-9424.20160176

Video：

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Objective To compare the therapy effect between surgical therapy and endoscopic therapy for chronic pancreatitis (CP) combined with pancreatic ductal stones (PDS). Methods Clinical data of 113 cases of CP combined with PDS who got treatment in Southwest Hospital of The Third Military Medical University between January 2010 and December 2015 were analyzed retrospectively, 84 of them underwent surgery (surgery group), and 29 of them got endoscopic therapy (endoscopy group). Results The operative time, intraoperative bleeding volume, postoperative hospital stay, and days in hospital, mortality, incidence of complication (pancreatic fistula, delayed gastric emptying, diabetes mellitus, and acute pancreatitis) of the surgery group were all higher than those of endoscopy group (P ＜0.05), but the ratios of the two-stage surgery and recurrence of PDS were all lower (P ＜00.05). The differences between symptom remission rate and residual stones rate were not statistically significant (P>0.05). Conclusions For cases of CP combined with PDS, the clinical therapy effect in symptom remission and residual stones between surgical and endoscopic therapy is similar, but compared with the endoscopic therapy, the operative time, intraoperative bleeding volume, postoperative hospital stay, and days in hospital of the surgical therapy are both longer. However, the ratios of the two-stage surgery and recurrence of PDS in the endoscopy group is significantly higher than those of surgery group.

Citation： GONGYi, WANGHuai-zhi. A Comparative Analysis of Effect Between Surgical and Endoscopic Therapy for Chronic Pancreatitis Combined with Pancreatic Ductal Stones. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(6): 654-657. doi: 10.7507/1007-9424.20160176 Copy

1.	Lieb JG 2nd, Palma DT, Garvan CW, et al. Intraobserver agreement among endosonographers for endoscopic ultrasound features of chronic pancreatitis: a blinded multicenter study. Pancreas, 2011, 40(2): 177-180.
2.	Weber A, Schneider J, Neu B, et al. Endoscopic stent therapy for patients with chronic pancreatitis—results from a prospective follow-up study. Pancreas, 2007, 34(3): 287-294.
3.	Korpela T, Udd M, Tenca A, et al. Long-term results of combined ESWL and ERCP treatment of chronic calcific pancreatitis. Scand J Gastroenterol, 2016, 51(7): 866-871.
4.	Díte P, Ruzicka M, Zboril V, et al. A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy, 2003, 35(7): 553-558.
5.	Wani NA, Parray FQ, Wani MA. Is any surgical procedure ideal for chronic pancreatitis?. Int J Surg, 2007, 5(1): 45-56.
6.	苗毅, 蒋奎荣. 慢性胰腺炎合并胰管结石的诊断和治疗. 中国实用外科杂志, 2011, 31(9): 800-803.
7.	Seicean A, Vultur S. Endoscopic therapy in chronic pancreatitis: current perspectives. Clin Exp Gastroenterol, 2014, 8: 1-11.
8.	Attwell AR, Patel S, Kahaleh M, et al. ERCP with per-oral pancreatoscopy- guided laser lithotripsy for calcific chronic pancreatitis: a multicenter U.S. experience. Gastrointest Endosc, 2015, 82(2): 311-318.
9.	Samejima Peternelli N, Wajsfeld T, Henrique Yazawa Santos F, et al. Postoperative complications of Beger procedure. Case Rep Surg, 2015, 2015: 970785.
10.	Beger HG, Witte C, Krautzberger W, et al. Experiences with duodenum- sparing pancreas head resection in chronic pancreatitis. Chirurg, 1980, 51(5): 303-307.
11.	Gloor B, Friess H, Uhl W, et al. A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis. Dig Surg, 2001, 18(1): 21-25.
12.	Pakosz-Golanowska M, Post M, Lubikowski J, et al. Partingtonrochelle pancreaticojejunostomy for chronic pancreatitis: analysis of outcome including quality of life. Hepatogastroenterology, 2009, 56(94-95): 1533-1537.
13.	Isaji S. Has the Partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence. J Hepatobiliary Pancreat Sci, 2010, 17(6): 763-769.
14.	Trunin MA, Shekhtel RV. Experience with using the Puestow-Gillesby operation (the first method), sparing the spleen, for chronic pancreatitis. Klin Khir, 1972, 6(1): 8-14.
15.	Díaz A, Yunge P, Urzúa Á, et al. Endoscopic treatment in chronic pancreatitis: long-term results in 18 patients. Rev Med Chil, 2015, 143(9): 1121-1128.
16.	Li BR, Liao Z, Du TT, et al. Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts. Gastrointest Endosc, 2015, 12(15): 42-44.
17.	Talukdar R, Reddy DN. Pancreatic endotherapy for chronic pancreatitis. Gastrointest Endosc Clin N Am, 2015, 25(4): 765-777.

1. Lieb JG 2nd, Palma DT, Garvan CW, et al. Intraobserver agreement among endosonographers for endoscopic ultrasound features of chronic pancreatitis: a blinded multicenter study. Pancreas, 2011, 40(2): 177-180.
2. Weber A, Schneider J, Neu B, et al. Endoscopic stent therapy for patients with chronic pancreatitis—results from a prospective follow-up study. Pancreas, 2007, 34(3): 287-294.
3. Korpela T, Udd M, Tenca A, et al. Long-term results of combined ESWL and ERCP treatment of chronic calcific pancreatitis. Scand J Gastroenterol, 2016, 51(7): 866-871.
4. Díte P, Ruzicka M, Zboril V, et al. A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy, 2003, 35(7): 553-558.
5. Wani NA, Parray FQ, Wani MA. Is any surgical procedure ideal for chronic pancreatitis?. Int J Surg, 2007, 5(1): 45-56.
6. 苗毅, 蒋奎荣. 慢性胰腺炎合并胰管结石的诊断和治疗. 中国实用外科杂志, 2011, 31(9): 800-803.
7. Seicean A, Vultur S. Endoscopic therapy in chronic pancreatitis: current perspectives. Clin Exp Gastroenterol, 2014, 8: 1-11.
8. Attwell AR, Patel S, Kahaleh M, et al. ERCP with per-oral pancreatoscopy- guided laser lithotripsy for calcific chronic pancreatitis: a multicenter U.S. experience. Gastrointest Endosc, 2015, 82(2): 311-318.
9. Samejima Peternelli N, Wajsfeld T, Henrique Yazawa Santos F, et al. Postoperative complications of Beger procedure. Case Rep Surg, 2015, 2015: 970785.
10. Beger HG, Witte C, Krautzberger W, et al. Experiences with duodenum- sparing pancreas head resection in chronic pancreatitis. Chirurg, 1980, 51(5): 303-307.
11. Gloor B, Friess H, Uhl W, et al. A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis. Dig Surg, 2001, 18(1): 21-25.
12. Pakosz-Golanowska M, Post M, Lubikowski J, et al. Partingtonrochelle pancreaticojejunostomy for chronic pancreatitis: analysis of outcome including quality of life. Hepatogastroenterology, 2009, 56(94-95): 1533-1537.
13. Isaji S. Has the Partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence. J Hepatobiliary Pancreat Sci, 2010, 17(6): 763-769.
14. Trunin MA, Shekhtel RV. Experience with using the Puestow-Gillesby operation (the first method), sparing the spleen, for chronic pancreatitis. Klin Khir, 1972, 6(1): 8-14.
15. Díaz A, Yunge P, Urzúa Á, et al. Endoscopic treatment in chronic pancreatitis: long-term results in 18 patients. Rev Med Chil, 2015, 143(9): 1121-1128.
16. Li BR, Liao Z, Du TT, et al. Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts. Gastrointest Endosc, 2015, 12(15): 42-44.
17. Talukdar R, Reddy DN. Pancreatic endotherapy for chronic pancreatitis. Gastrointest Endosc Clin N Am, 2015, 25(4): 765-777.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

A Comparative Analysis of Effect Between Surgical and Endoscopic Therapy for Chronic Pancreatitis Combined with Pancreatic Ductal Stones

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