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Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts.
Gastrointest Endosc. 2016 Jul; 84(1):69-78.GE

Abstract

BACKGROUND AND AIMS

We aimed to investigate outcomes of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) for the removal of large pancreatic stones coexisting with pancreatic pseudocysts (PPCs) in chronic pancreatitis (CP).

METHODS

This is a prospective study performed in CP patients with at least 1 stone (≥5 mm). Patients were divided into the PPC group (stones coexisting with PPCs) or the control group (stones alone). Patients were initially subjected to successive P-ESWL treatments, followed by ERCP. Primary outcomes were P-ESWL adverse events, and secondary outcomes were stone clearance, long-term pain relief, improved quality-of-life scores, and PPC regression.

RESULTS

A total of 849 patients (59 in the PPC group and 790 in the control group) was subjected to P-ESWL between March 2011 and October 2013. Occurrences of P-ESWL adverse events were similar between the PPC group and the control group (11.86% vs 12.41%, P = .940). After the treatment of initial P-ESWL combined with ERCP, the complete, partial, and nonclearance of stones occurred in 67.24%, 20.69%, and 12.07%, respectively, of patients in PPC group, with no significant difference from the control group (complete, partial, and nonclearance: 83.17%, 10.40%, and 11.39%, respectively; P = .106). Fifty-five of 59 patients (93.22%) with PPCs were followed for a median period of 21.9 months (range, 12.0-45.1). PPCs disappeared in 56.36% (31/55) and 76.36% (42/55) of patients after 3 months and 1 year of follow-up visits, respectively. Moreover, complete and partial pain relief were achieved in 63.64% (35/55) and 25.45% (14/55) of patients, respectively. The scores for quality of life (P < .001), physical health (P < .001), and weight loss (P < .001) improved.

CONCLUSIONS

In our multispecialty tertiary center, initial P-ESWL followed by ERCP was safe in patients with coexisting pancreatic stones and PPCs and effective for stone clearance, main pancreatic duct drainage, and pain relief.

Authors+Show Affiliations

Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China; Department of Gastroenterology, Air Force General Hospital, Beijing, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Air Force General Hospital, Beijing, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26542375

Citation

Li, Bai-Rong, et al. "Extracorporeal Shock Wave Lithotripsy Is a Safe and Effective Treatment for Pancreatic Stones Coexisting With Pancreatic Pseudocysts." Gastrointestinal Endoscopy, vol. 84, no. 1, 2016, pp. 69-78.
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. 2016;84(1):69-78.
Li, B. R., Liao, Z., Du, T. T., Ye, B., Chen, H., Ji, J. T., Zheng, Z. H., Hao, J. F., Ning, S. B., Wang, D., Lin, J. H., Hu, L. H., & Li, Z. S. (2016). Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts. Gastrointestinal Endoscopy, 84(1), 69-78. https://doi.org/10.1016/j.gie.2015.10.026
Li BR, et al. Extracorporeal Shock Wave Lithotripsy Is a Safe and Effective Treatment for Pancreatic Stones Coexisting With Pancreatic Pseudocysts. Gastrointest Endosc. 2016;84(1):69-78. PubMed PMID: 26542375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts. AU - Li,Bai-Rong, AU - Liao,Zhuan, AU - Du,Ting-Ting, AU - Ye,Bo, AU - Chen,Hui, AU - Ji,Jun-Tao, AU - Zheng,Zhao-Hong, AU - Hao,Jun-Feng, AU - Ning,Shou-Bin, AU - Wang,Dan, AU - Lin,Jin-Huan, AU - Hu,Liang-Hao, AU - Li,Zhao-Shen, Y1 - 2015/11/02/ PY - 2015/05/21/received PY - 2015/10/13/accepted PY - 2015/11/7/entrez PY - 2015/11/7/pubmed PY - 2017/8/10/medline SP - 69 EP - 78 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 84 IS - 1 N2 - BACKGROUND AND AIMS: We aimed to investigate outcomes of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) for the removal of large pancreatic stones coexisting with pancreatic pseudocysts (PPCs) in chronic pancreatitis (CP). METHODS: This is a prospective study performed in CP patients with at least 1 stone (≥5 mm). Patients were divided into the PPC group (stones coexisting with PPCs) or the control group (stones alone). Patients were initially subjected to successive P-ESWL treatments, followed by ERCP. Primary outcomes were P-ESWL adverse events, and secondary outcomes were stone clearance, long-term pain relief, improved quality-of-life scores, and PPC regression. RESULTS: A total of 849 patients (59 in the PPC group and 790 in the control group) was subjected to P-ESWL between March 2011 and October 2013. Occurrences of P-ESWL adverse events were similar between the PPC group and the control group (11.86% vs 12.41%, P = .940). After the treatment of initial P-ESWL combined with ERCP, the complete, partial, and nonclearance of stones occurred in 67.24%, 20.69%, and 12.07%, respectively, of patients in PPC group, with no significant difference from the control group (complete, partial, and nonclearance: 83.17%, 10.40%, and 11.39%, respectively; P = .106). Fifty-five of 59 patients (93.22%) with PPCs were followed for a median period of 21.9 months (range, 12.0-45.1). PPCs disappeared in 56.36% (31/55) and 76.36% (42/55) of patients after 3 months and 1 year of follow-up visits, respectively. Moreover, complete and partial pain relief were achieved in 63.64% (35/55) and 25.45% (14/55) of patients, respectively. The scores for quality of life (P < .001), physical health (P < .001), and weight loss (P < .001) improved. CONCLUSIONS: In our multispecialty tertiary center, initial P-ESWL followed by ERCP was safe in patients with coexisting pancreatic stones and PPCs and effective for stone clearance, main pancreatic duct drainage, and pain relief. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/26542375/Extracorporeal_shock_wave_lithotripsy_is_a_safe_and_effective_treatment_for_pancreatic_stones_coexisting_with_pancreatic_pseudocysts_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(15)03042-4 DB - PRIME DP - Unbound Medicine ER -