Oral Litholysis in Patients with Chronic Calcific Pancreatitis Unresponsive to or Ineligible for Extracorporeal Shock Wave Lithotripsy and Endoscopic Therapy
| Autor: | Masato Maekawa, Yoshinori Wakita, Hiroaki Nakagawa, Junko Izumi, Jun Usami, Nobuo Ashizawa, Shunsuke Inamoto, Aiji Noda, Koichi Hamano, Eri Ibuki |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Cholangiopancreatography Magnetic Resonance medicine.medical_treatment Administration Oral Trimethadione Gastroenterology Calculi Calcium Carbonate Impaired glucose tolerance 03 medical and health sciences 0302 clinical medicine Recurrence Lithotripsy Pancreatitis Chronic Internal medicine Diabetes mellitus medicine Humans Pancreatic stones In patient Aged Cholangiopancreatography Endoscopic Retrograde Original Paper business.industry Pancreatic Ducts Middle Aged medicine.disease Extracorporeal shock wave lithotripsy Treatment Outcome 030220 oncology & carcinogenesis Pancreatitis Female 030211 gastroenterology & hepatology business Body mass index medicine.drug |
| Zdroj: | Digestion. 100:55-63 |
| ISSN: | 1421-9867 0012-2823 |
| DOI: | 10.1159/000495608 |
| Popis: | Background/Aims: Our study aimed to evaluate the effect of oral litholysis in patients with chronic calcific pancreatitis (CCP) unresponsive to or ineligible for extracorporeal shock wave lithotripsy (ESWL) and endoscopic therapy. Methods: Trimethadione, an antiepileptic agent, was administered orally at a dose of 0.6–0.9 g/day to 15 patients with this condition. Treatment outcome was evaluated by assessment of dissolution of the pancreatic stones on plain X-ray films and computed tomography scans of the upper abdomen. Plasma glucose, hemoglobin A1c, and body mass index (BMI) were also monitored throughout the therapy. Results: Litholysis was observed in 13 out of 15 patients (86.7%) and was definite in 10 and partial in 3. Six patients had pancreatitis attacks during the therapy; 5 of whom showed definite litholysis and had only 1 mild attack. Of the 11 patients with normal or impaired glucose tolerance at baseline, none developed diabetes mellitus and all showed litholysis. BMI significantly increased in patients whose pancreatic stones dissolved. There was no vital organ impairment by trimethadione. Conclusion: Oral litholysis using trimethadione may represent a noninvasive and effective complementary treatment in patients with CCP unresponsive to or ineligible for ESWL and endoscopic therapy. |
| Databáze: | OpenAIRE |
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