Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts
Autor: | Bo Ye, Jin-Huan Lin, Dan Wang, Zhuan Liao, Jun-Tao Ji, Shou-Bin Ning, Hui Chen, Ting-Ting Du, Zhao-Hong Zheng, Liang-Hao Hu, Bai-Rong Li, Zhao-Shen Li, Jun-Feng Hao |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent Pancreatic pseudocyst SF-36 medicine.medical_treatment Hemorrhage Lithotripsy Calculi Endosonography Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Quality of life Pancreatitis Chronic Pancreatic Pseudocyst medicine Humans Surgical Wound Infection Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Adverse effect Cholangiopancreatography Endoscopic Retrograde business.industry Gastroenterology Pancreatic Diseases Middle Aged medicine.disease Magnetic Resonance Imaging Extracorporeal shock wave lithotripsy Surgery Treatment Outcome Pancreatitis Radiology Nuclear Medicine and imaging Case-Control Studies 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Tomography X-Ray Computed business |
Zdroj: | Gastrointestinal Endoscopy. 84:69-78 |
ISSN: | 0016-5107 |
Popis: | Background and AimsWe 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).MethodsThis 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.ResultsA 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.ConclusionsIn 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. |
Databáze: | OpenAIRE |
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