Adverse events of pancreatic extracorporeal shock wave lithotripsy: a literature review

Abstract

Pancreatic stones are the result of pathophysiologic changes in chronic pancreatitis with an incidence of more than 90%. At present, pancreatic extracorporeal shock wave lithotripsy (P-ESWL) can be used as the first-line treatment for large or complex stones. Although a large number of studies have proven the safety and effectiveness of P-ESWL, we should also pay attention to postoperative adverse events, mainly due to the scattering of shock waves in the conduction pathway. Adverse events can be classified as either complications or transient adverse events according to the severity. Because the anatomic location of organs along the shock wave conducting pathway differs greatly, adverse events after P-ESWL are varied and difficult to predict. This paper outlines the mechanism, definition, classification, management and risk factors for adverse events related to P-ESWL. It also discusses the technique of P-ESWL, indications and contraindications of P-ESWL, and adverse events in special populations.

Management of chronic pancreatitis: recent advances and future prospects

“…Extracorporeal shock wave lithotripsy (ESWL) is a highly effective treatment method for pancreatic stone fragmentation, especially for stones larger than 5 mm. 63 , 64 Previous retrospective cohort studies have shown that ESWL is safe and effective for CP patients, even for those who are geriatric, 65 pediatric, 66 postoperative, 67 or with pancreatic pseudocysts. 68 However, the evidence from RCT on the safety and efficacy of ESWL on pancreatic stones is still of scarcity.…”