Extracorporeal shock wave lithotripsy (ESWL) for large pancreatic stones: are these shocks worth while?

Bhasin, Deepak K.; Rana, Surinder Singh

doi:10.1007/s12664-010-0039-7

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…However, a few patients may suffer from adverse events caused by related stone fragments and injury to the tissues surrounding the pancreas. Given the lack of established definition and classification for the adverse events of P-ESWL, the reported prevalence varies from 0 % to 20 % [10]. The adverse events include skin erythema, hematuria, post-ESWL pancreatitis, bleeding, and perforation [5 -7, 11 -16].…”

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confidence: 99%

Risk factors for complications of pancreatic extracorporeal shock wave lithotripsy

Liao

et al. 2014

Endoscopy

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Background and study aims: Extracorporeal shock wave lithotripsy is recommended as treatment for stones in chronic pancreatitis. The aim of this study was to investigate the risk factors for complications of pancreatic extracorporeal shock wave lithotripsy (P-ESWL). Patients and methods: Patients with painful chronic pancreatitis and pancreatic stones (>?5?mm diameter) who were treated with P-ESWL between March 2011 and June 2013 were prospectively included. Adverse events after P-ESWL were classified as complications and transient adverse events, depending on severity. The major complications of P-ESWL included post-ESWL pancreatitis, bleeding, infection, steinstrasse, and perforation. Multivariate analyses based on univariate analysis were performed to detect risk factors of overall and moderate-to-severe complications. Results: A total of 634 patients underwent 1470 P-ESWL procedures. The overall complication rate was 6.7?% of all procedures. Complications occurred in 62 patients (9.8?%) after the first ESWL procedure. The risk factors for complications were pancreas divisum (odds ratio [OR] 1.28) and the interval between diagnosis of chronic pancreatitis and P-ESWL (OR 1.28). Protective factors were male sex (OR 0.50), diabetes (OR 0.45), and steatorrhea (OR 0.43). Male sex, the only identified predictor for moderate-to-severe complications, was a protective factor (OR 0.19). For the second P-ESWL procedure, complications occurred in 22/409 patients (5.4?%). Complication and asymptomatic hyperamylasemia after the first ESWL session were significantly associated with higher risk for complications after the second ESWL session (P?

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confidence: 99%

Risk factors for complications of pancreatic extracorporeal shock wave lithotripsy

Liao

et al. 2014

Endoscopy

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“…However, the presence of multiple MPD stones, large radiolucent stones, and the presence of MPD strictures with impacted stones offer a significant challenge to the endoscopist. These can be managed in two ways: either by decreasing the stone size or by enlarging the ampullary orifice 9 .…”

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confidence: 99%

Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients

et al. 2017

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Background and aim There is paucity of data about endoscopic pancreatic sphincteroplasty (EPS) after endoscopic pancreatic sphincterotomy (EPST) in the treatment of chronic pancreatitis. The aim of this study was to establish the indications for EPS, complications related to it, and to examine its effectiveness in managing chronic pancreatitis after a year of follow-up. Methods We evaluated the safety and efficacy of pancreatic balloon dilation coupled with sphincterotomy for the treatment of chronic pancreatitis. The technical success rate of balloon dilation, stone clearance, frequency of pancreatic stenting, and procedure-related adverse events were recorded. Results Out of 580 patients who underwent pancreatic endotherapy between July 2014 and February 2016, 80 patients underwent EPS. The mean age of these 80 patients was 34 ± 11 years, and 80 % (n = 64) were males. The common indications were removal of large radiolucent stones in 31 patients; unyielding radiopaque stones post extracorporeal shock wave lithotripsy (ESWL) in 20 patients, and pancreatic duct stricture combined with stones in 29 patients. EPS could be successfully completed in 98.75 % of patients. Complete ductal clearance in a single session was achieved in only 25 patients, while 26 patients required two sessions. There were two adverse events of pain requiring admission for more than 24 hours and one procedure related bleeding, all of which were managed conservatively. The patients had an average follow-up of 8 months (6 – 12 months) and all the patients were pain free. Conclusions Endoscopic pancreatic sphincteroplasty is a relatively safe procedure with a low incidence of complications and a high rate of treatment success.

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“…Only a few studies on P-ESWL involve patients with PPC; thus, insufficient information is available about the possibility of PPC-related adverse events, 9,18 such as pseudoaneurysm, 19 rupture, and bleeding. The few studies that include PPC cases presented no specific safety evaluation of these patients.…”

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Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts

Liao

et al. 2016

Gastrointestinal Endoscopy

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Extracorporeal shock wave lithotripsy (ESWL) for large pancreatic stones: are these shocks worth while?

Cited by 4 publications

References 30 publications

Risk factors for complications of pancreatic extracorporeal shock wave lithotripsy

Risk factors for complications of pancreatic extracorporeal shock wave lithotripsy

Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients

Extracorporeal shock wave lithotripsy is a safe and effective treatment for pancreatic stones coexisting with pancreatic pseudocysts

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