慢性膵炎
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2 performance statusps body mass indexbmi - - ESWL 40
3 - Stage ; 16 : - Ramesh H. Proposal for a new grading system for chronic pancreatitis. J Clin Gastroenterol ; 35 : - Bagul A, Siriwardena AK. Evaluation of the Manchester classification system for chronic pancreatitis. JOP ; 7 : - ; 95 : -. Ammann RW. A clinically based classification system for alcoholic chronic pancreatitis : summary of an international workshop on chronic pancreatitis. Pancreas ; 14 : - Chari ST, Singer MV. The problem of classification and staging of chronic pancreatitis. Scand J Gastroenterol ; 29 : - Gabbrielli A, Mutignani M, Pandolfi M, et al. Endotherapy of early onset idiopathic chronic pancreatitis : results with long-term follow-up. Gastrointest Endosc ; 55 : - Rosch T, Daniel S, Scholz M, et al. Endoscopic treatment of chronic pancreatitis : a multicenter study of patients with long-term follow-up. Endoscopy ; 34 : - Costamagna G, Gabbrielli A, Mutignani M, et al. Extracorporeal shock wave lithotripsy of pancreatic stones in chronic pancreatitis : immediate and medium-term results. Gastrointest Endosc ; 46 : - Lankisch PG, Andren-Sandberg A. Standards for the diagnosis of chronic pancreatitis and for the evaluation of treatment. Int J Pancreatol ; 14 : - 41
4 - - ESWL DPPHR quality of lifeqol - 42
5 Stage ; 16 : - Ramesh H. Proposal for a new grading system for chronic pancreatitis. J Clin Gastroenterol ; 35 : - Bagul A, Siriwardena AK. Evaluation of the Manchester classification system for chronic pancreatitis. JOP ; 7 : - ; 95 : - Ammann RW. A clinically based classification system for alcoholic chronic pancreatitis : summary of an international workshop on chronic pancreatitis. Pancreas ; 14 : - Chari ST, Singer MV. The problem of classification and staging of chronic pancreatitis. Scand J Gastroenterol ; 29 : - Ammann RW, Muellhaupt B, Zurich Pancreatic Study Group. The natural history of pain in alcoholic chronic pancreatitis. Gastroenterology ; 116 : - Ammann RW, Akovbiantz A, Largiader F, et al. Course and outcome of chronic pancreatitis : longitudinal study of a mixed medical-surgical series of patients. Gastroenterology ; 86 : - Lankisch PG, Lohr-Happe A, Otto J, et al. Natural course in chronic pancreatitis. Digestion ; 54 : - p- Gabbrielli A, Mutignani M, Pandolfi M, et al. Endotherapy of early onset idiopathic chronic pancreatitis : results with long-term follow-up. Gastrointest Endosc ; 55 : - Bloechle C, Izbicki JR, Knoefel WT, et al. Quality of life in chronic pancreatitis-results after duodenum-preserving resection of the head of the pancreas. Pancreas ; 11 : - 43
6 Izbicki JR, Bloechle C, Knoefel WT, et al. Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis : a prospective, randomized trial. Ann Surg ; 221 : - Glasbrenner B, Adler G. Evaluating pain and the quality of life in chronic pancreatitis. Int J Pancreatol ; 22 : - 44
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8 Berk JE, Ayulo JA, Fridhandler L. Value of pancreatic-type isoamylase assay as an index of pancreatic insufficiency. Dig Dis Sci ; 24 : - EIA ; 4 ; - Ventrucci M, Gullo L, Daniele C, et al. Comparative study of serum pancreatic isoamylase, lipase, and trypsin-like immunoreactivity in pancreatic disease. Digestion ; 28 ; - Nasrallah SM, Martin DM. Serum isoamylase as a test for pancreatic insufficiency. Gut ; 24 : - Dominguez-Munoz JE, Pieramino O, Buchler M, et al. Ratios of different serum pancreatic enzymes in the diagnosis and staging of chronic pancreatitis. Digestion ; 54 : - IRYO ; 45 : - 46
9 ERCP,, - - EUS 47
10 - - ERCP Kasugai T, Kuno N, Kizu M, et al. Endoscopic pancreatocholangio- graphy. II. The pathological endoscopic pancreatocholangiogram. Gastroenterology ; 63 : - Sarner M, Cotton PB. Classification of pancreatitis. Gut ; 25 : - Lankisch PG, Seidensticker F, Otto J, et al. Secretin-pancreozymin test (SPT) and endoscopic retrograde cholangiopancreatography (ERCP) : both are necessary for diagnosing or excluding chronic pancreatitis. Pancreas ; 12 : - ; 14 : - Stage p- Stage ; 16 : - Kasugai T, Tanehiro K, Kurimoto K, et al. Progression of radiological changes in relapsing and chronic pancreatitis. J Gastroenterol Hepatol ; 4 : - Kamisawa T, Matsukawa M, Yoshiike M, et al. Chronic pancreatitis progressing from segmental lesions. Hepatogastroenterology ; 52 : - Nagata A, Homma T, Tamai K, et al. A study of chronic pancreatitis by serial endoscopic pancreatography. Gastroenterology ; 81 : - Otsuki M. Chronic pancreatitis : the problems of diagnostic criteria. Pancreatology ; 4 : - Kahl S, Glasbrenner B, Leodolter A, et al. EUS in the diagnosis of early chronic pancreatitis : a prospective follow-up study. Gastrointest Endosc ; 55 : - Sahai AV, Zimmerman M, Aabakken L, et al. Prospective assessment of the ability of endoscopic ultrasound to diagnose, exclude, or establish the sensitivity of chronic pancreatitis found by endoscopic retrograde cholangiopancreatography. Gastrointest Endosc ; 48 : - Catalano MF, Lahoti S, Geenen JE, et al. Prospective evaluation of endoscopic ultrasonography, endoscopic retrograde pancreatography, and secretin test in the diagnosis of chronic pancreatitis. Gastrointest Endosc ; 11 : - 48
11 Gabbrielli A, Mutignani M, Pandolfi M, et al. Endotherapy of early onset idiopathic chronic pancreatitis : results with long-term follow-up. Gastrointest Endosc ; 55 : - Rosch T, Daniel S, Scholz M, et al. Endoscopic treatment of chronic pancreatitis : a multicenter study of patients with long-term follow-up. Endoscopy ; 34 : - Costamagna G, Gabbrielli A, Mutignani M, et al. Extracorporeal shock wave lithotripsy of pancreatic stones in chronic pancreatitis : immediate and medium-term results. Gastrointest Endosc ; 46 : - 49
12 gold standard, ERCP, 50
13 C-benzoyl-L-tyrosyl-[- C] alaninebz-tyr-alabt-paba -, BT- PABA, BT-PABA - BT-PABA Lankisch PG, Lembcke B, Wemken G, et al. Functional reserve capacity of the exocrine pancreas. Digestion ; 35 : - ; 16 : - Hayakawa T, Kondo T, Shibata T. Relationship between pancreatic exocrine function and histological changes in chronic pancreatitis. Am J Gastroenterol ; 87 : - Mee AS, Girdwood AH, Walker E, et al. Comparison of the oral (PABA) pancreatic function test, the secretin-pancreozymin test and endoscopic retrograde pancreatography in chronic alcohol induced pancreatitis. Gut ; 26 : - Kitagawa M, Naruse S, Ishiguro H, et al. Evaluating exocrine function tests for diagnosing chronic pancreatitis. Pancreas ; 15 : - Kataoka K, Yamane Y, Kato M, et al. Diagnosis of chronic pancreatitis using noinvasive test of exocrine pancreatic function-comparison to duodenal intubation tests. Pancreas ; 15 : - I ; 117 : - C-Benzoyl-L-Tyrosyl-[- C]alanine ; 39 : - 51
14 52
15 OGTT - OGTT 53
16 β α β α OGTT C-CPR C- CPR, CPR α, ; : - B glucagon infusion test vial mg C- CPR CPR. ng/ml. ng/ml 54
17 arginine infusion test ml L- g pg/ml pg/ml Maartense S, Ledeboer M, Masclee AA. Chronic pancreatitis : relation between function and morphology. Dig Liver Dis ; 36 : - Koizumi M, Yoshida Y, Abe N, et al. Pancreatic diabetes in Japan. Pancreas ; 16 : - Cavallini G, Vaona B, Bovo P, et al. Diabetes in chronic alcoholic pancreatitis : role of residual beta cell function and insulin resistance. Dig Dis Sci ; 38 : - ; 4 : - Cavallini G, Bovo P, Zamboni M, et al. Exocrine and endocrine functional reserve in the course of chronic pancreatitis as studied by maximal stimulation tests. Dig Dis Sci ; 37 : - ERCP ; 29 : - von Tirpitz C, Glasbrenner B, Mayer D, et al. Comparison of different endocrine stimulation tests in nondiabetic patients with chronic pancreatitis. Hepatogastroenterology ; 45 : - 55
18 ERCP pancreatic polypeptidepp BT-PABA OGTT PP 56
19 ERCP/MRCP/CT Manchester PS BMI Ammann RW. A clinically based classification system for alcoholic chronic pancreatitis : summary of an International Workshop on Chronic Pancreatitis. Pancreas ; 14 : - Nealon WH, Townsend Jr CM, Thompson JC. The time course of beta cell dysfunction in chronic ethanol-induced pancreatitis : a prospective analysis. Surgery ; 104 : - Bagul A, Siriwardena AK. Evaluation of the Manchester classification system for chronic pancreatitis. JOP ; 7 : - Stage ; 16 : - 57
20 58
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慢性膵炎
ESWL -, 174 -. Costamagna G, Gabbrielli A, Mutignani M, et al. Extracorporeal shock wave lithotripsy of pancreatic stones in chronic pancreatitis : immediate and medium-term results. Gastrointest Endosc
慢性膵炎
- - 121 , g CCK g g - kgkcal kgkcal - g,,, - G.I.Res ; 10 : - ; 13 : - ; 22 : - Meier RF, Beglinger C. Nutrition in pancreatic diseases. Best Pract Res Clin Gastroenterol ; 20 : - Pfutzer RH, Schneider
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Cumulative %PABA recovery in urine (6h.) Fig. 1 PABA recovery in urine after oral administration of 0.5g BT-PABA Cumulative %PABA recovery in urine (6h.) Fig. 2 PABA recovery in urine after oral administration
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