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Long-term clinical outcomes of extracorporeal shockwave lithotripsy in painful chronic calcific pancreatitis.
Gastrointest Endosc. 2013 Nov; 78(5):726-33.GE

Abstract

BACKGROUND

Long-term results of extracorporeal shockwave lithotripsy (ESWL) for large pancreatic duct (PD) stones in patients with idiopathic calcific pancreatitis (CP) are scanty.

OBJECTIVE

To evaluate intermediate and long-term results of ESWL in a large cohort of patients with idiopathic CP.

DESIGN

Cross-sectional study; retrospective chart review.

SETTING

A high-volume, tertiary-care center for endoscopy and GI diseases.

PATIENTS

A total of 636 patients with idiopathic CP who underwent ESWL and ERCP were followed-up. Patients were divided into intermediate (24-60 months) and long-term (>60 months) follow-up groups.

INTERVENTION

ESWL and ERCP.

MAIN OUTCOME MEASUREMENTS

Improvement in pain, analgesic use, hospitalization for pain, recurrence of calculi, need for additional intervention, and quality of life.

RESULTS

A total of 636 of 1006 patients who underwent ESWL between 2004 and 2009 were followed for a maximum of 96 months. There were 364 patients in the intermediate follow-up group and 272 in the long-term follow-up group. After ESWL and ERCP, absence of pain was seen in 250 patients (68.7%), mild-to-moderate pain in 94 patients (25.4%), and severe pain in 20 patients (5.5%) of the intermediate group. In the long-term group, 164 patients (60.3%) had no pain, 97 patients (35.7%) had mild or moderate episodes of pain, whereas 11 patients (4.04%) had episodic severe pain. Recurrence of calculi was seen in 51 patients (14.01%) in the intermediate follow-up group and in 62 patients (22.8%) in the long-term group. Quality of life improved in a significant number of patients in both groups.

LIMITATIONS

Retrospective study, single center, recall bias, and subjective pain and quality-of-life measurement scale.

CONCLUSION

ESWL for large PD calculi offers good results in patients of idiopathic CP on intermediate and long-term follow-up.

Authors+Show Affiliations

Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23891416

Citation

Tandan, Manu, et al. "Long-term Clinical Outcomes of Extracorporeal Shockwave Lithotripsy in Painful Chronic Calcific Pancreatitis." Gastrointestinal Endoscopy, vol. 78, no. 5, 2013, pp. 726-33.
Tandan M, Reddy DN, Talukdar R, et al. Long-term clinical outcomes of extracorporeal shockwave lithotripsy in painful chronic calcific pancreatitis. Gastrointest Endosc. 2013;78(5):726-33.
Tandan, M., Reddy, D. N., Talukdar, R., Vinod, K., Santosh, D., Lakhtakia, S., Gupta, R., Ramchandani, M. J., Banerjee, R., Rakesh, K., Varadaraj, G., & Rao, G. V. (2013). Long-term clinical outcomes of extracorporeal shockwave lithotripsy in painful chronic calcific pancreatitis. Gastrointestinal Endoscopy, 78(5), 726-33. https://doi.org/10.1016/j.gie.2013.05.012
Tandan M, et al. Long-term Clinical Outcomes of Extracorporeal Shockwave Lithotripsy in Painful Chronic Calcific Pancreatitis. Gastrointest Endosc. 2013;78(5):726-33. PubMed PMID: 23891416.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term clinical outcomes of extracorporeal shockwave lithotripsy in painful chronic calcific pancreatitis. AU - Tandan,Manu, AU - Reddy,Duvvur Nageshwar, AU - Talukdar,Rupjyoti, AU - Vinod,Koppuju, AU - Santosh,Darisetty, AU - Lakhtakia,Sundeep, AU - Gupta,Rajesh, AU - Ramchandani,Mohan J, AU - Banerjee,Rupa, AU - Rakesh,Kalapala, AU - Varadaraj,Gokak, AU - Rao,Guduru Venkat, Y1 - 2013/07/25/ PY - 2013/02/22/received PY - 2013/05/10/accepted PY - 2013/7/30/entrez PY - 2013/7/31/pubmed PY - 2014/5/30/medline KW - CP KW - ESWL KW - Hb(A1c) KW - MPD KW - MRCP KW - Magnetic resonance cholangiopancreatography KW - PD KW - calcific pancreatitis KW - extracorporeal shockwave lithotripsy KW - glycosylated hemoglobin KW - main pancreatic duct KW - pancreatic duct SP - 726 EP - 33 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 78 IS - 5 N2 - BACKGROUND: Long-term results of extracorporeal shockwave lithotripsy (ESWL) for large pancreatic duct (PD) stones in patients with idiopathic calcific pancreatitis (CP) are scanty. OBJECTIVE: To evaluate intermediate and long-term results of ESWL in a large cohort of patients with idiopathic CP. DESIGN: Cross-sectional study; retrospective chart review. SETTING: A high-volume, tertiary-care center for endoscopy and GI diseases. PATIENTS: A total of 636 patients with idiopathic CP who underwent ESWL and ERCP were followed-up. Patients were divided into intermediate (24-60 months) and long-term (>60 months) follow-up groups. INTERVENTION: ESWL and ERCP. MAIN OUTCOME MEASUREMENTS: Improvement in pain, analgesic use, hospitalization for pain, recurrence of calculi, need for additional intervention, and quality of life. RESULTS: A total of 636 of 1006 patients who underwent ESWL between 2004 and 2009 were followed for a maximum of 96 months. There were 364 patients in the intermediate follow-up group and 272 in the long-term follow-up group. After ESWL and ERCP, absence of pain was seen in 250 patients (68.7%), mild-to-moderate pain in 94 patients (25.4%), and severe pain in 20 patients (5.5%) of the intermediate group. In the long-term group, 164 patients (60.3%) had no pain, 97 patients (35.7%) had mild or moderate episodes of pain, whereas 11 patients (4.04%) had episodic severe pain. Recurrence of calculi was seen in 51 patients (14.01%) in the intermediate follow-up group and in 62 patients (22.8%) in the long-term group. Quality of life improved in a significant number of patients in both groups. LIMITATIONS: Retrospective study, single center, recall bias, and subjective pain and quality-of-life measurement scale. CONCLUSION: ESWL for large PD calculi offers good results in patients of idiopathic CP on intermediate and long-term follow-up. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/23891416/Long_term_clinical_outcomes_of_extracorporeal_shockwave_lithotripsy_in_painful_chronic_calcific_pancreatitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(13)01909-3 DB - PRIME DP - Unbound Medicine ER -