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
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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