<原著>石灰化膵石症および蛋白栓や粘稠膵液に対する経口膵石溶解療法の効果

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The effect of the oral litholysis therapy (OLT) was studied in patients with calcific pancreatic stones, protein plugs and suspected secretion of viscous pancreatic juice. Dimethadione is a weak organic acid, and can dissolve calcium carbonate which is a main constituent of pancreatic stones. In the present study, trimethadione was given orally as a precursor of dimethadione to 37 patients with calcific pancreatitis. The 37 patients not treated with trimethadione were selected as a control. 0n plain X-ray films and CT scans of the abdomen, pancreatic stones significantly diminished in size and number or disappeared in 24 patients (64.9%) (p<0.05,vs the control). During the OLT, the impaired exocrine pancreatic function returned to normal in 33.3% of the patients examined (p<0.05, vs the control), diabetes mellitus was well controlled by either diet therapy alone or oral hypoglycemic agents in 56.3% of the patients, and complete relief of pain was attained in 76.2% of the patients (p<0.05, vs the control). Mild photophobia was the most common side effect, but no severe side effects were observed. In the control group, pancreatic stones neither disappeared nor diminished spontaneously. In another study, a mucolytic expectorant, bromhexine-hydrochloride was given orally to 4 patients with a suspected functional stenosis or obstruction of pancreatic ducts by either protein plugs or viscous pancreatic juice, or both. During the treatment, both complete pain relief and disappearance of protein plugs were observed in 3 patients who suffered from the recurrent pain, the exocrine pancreatic dysfunction, which was observed in one patient, was significantly improved, and no deterioration of diabetes mellitus was observed in any of the patients. In conclusion, we believe that the OLT by trimethadione or bromhexine-hydro-chloride becomes a useful tool for chemical dissolution of calcific pancreatic stones or for recurrent pain relief by eliminating protein plugs and viscous pancreatic juice.
愛知医科大学の論文
2002-12-15

<原著>石灰化膵石症および蛋白栓や粘稠膵液に対する経口膵石溶解療法の効果

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