Extracorporeal Shock Wave Lithotripsy for Chinese Patients With Pancreatic Stones

Hu, Liang‐Hao; Ye, Bo; Yang, Yan-Jun; Ji, Jun-Tao; Zou, Wenbin; Du, Tingting; Hao, Junfeng; Ying-yi, Jiang; Liao, Zhuan; Li, Zhao‐Shen

doi:10.1097/mpa.0000000000000464

Cited by 57 publications

(60 citation statements)

References 38 publications

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“…The risk of complications relating to P‐ESWL was not increased in geriatric patients, and the efficacy of P‐ESWL was demonstrated by the significant pain relief and effective stone clearance. The outcome was similar to the results of previous P‐ESWL studies in young patients …”

Section: Discussionsupporting

confidence: 89%

“…P‐ESWL has been successfully applied in the treatment of pancreatic stones since 1987 and is now recommended as the first‐line therapy for young patients with uncomplicated painful CP and radiopaque stones ≥ 5 mm obstructing the MPD . The safety and efficacy of P‐ESWL have been demonstrated in numerous studies, but data for geriatric patients have not been previously reported . Our study is the first to report the safety and efficacy of P‐ESWL in geriatrics.…”

Section: Discussionmentioning

confidence: 83%

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Extracorporeal shock wave lithotripsy is safe and effective for geriatric patients with chronic pancreatitis

Liang

Liu

Wang

et al. 2019

J of Gastro and Hepatol

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Background and Aim Pancreatic extracorporeal shock wave lithotripsy (P‐ESWL) is a first‐line treatment for chronic pancreatitis (CP) patients with pancreatic stones. However, the performance of P‐EWSL in geriatric patients remains unclear. We aimed to evaluate the safety and efficacy of P‐ESWL for them. Methods This prospective study was conducted in painful CP patients who underwent P‐ESWL. Patients aged over 65 years were included in geriatric group; patients aged under 65 years were assigned to control group. For the long‐term follow‐up investigation, geriatric patients were matched with patients from the control group in a 1:1 ratio. Primary outcomes were complications of P‐ESWL and pain relief. Secondary outcomes included stone clearance, physical and mental health, quality of life score, changes in exocrine and endocrine pancreatic function, and survival. Results From March 2011 to March 2016, P‐ESWL was performed in 1404 patients (72 in the geriatric group and 1332 in the control group). No significant differences were observed in complications of P‐ESWL between the two groups (P = 0.364). Among the 67 (67/72, 93.1%) geriatric patients who underwent follow up for 4.02 years, complete pain relief was achieved in 53 patients, which was not significantly different from that of matched controls (54/70; P = 0.920). The death in the geriatrics was significantly higher (P = 0.007), but none of them were correlated with P‐ESWL. Conclusions P‐ESWL is safe and effective for geriatric CP patients with pancreatic stones. It can promote significant pain relief and stone clearance and improve quality of life and mental and physical health.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 83%

Extracorporeal shock wave lithotripsy is safe and effective for geriatric patients with chronic pancreatitis

Liang

Liu

Wang

et al. 2019

J of Gastro and Hepatol

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“…1 In biliary stones ESWL, first reported in 1989, is successful in clearing 84-89% of stones, with cholangitis as the main adverse effect. 8,9 Recently, a prospective study including 214 chronic pancreatitis patients showed similar MPD clearance rates, with a 4% complication rate reported. 10 This study also showed that more than 50% of patients needed at least two ESWL sessions and up to 11% needed more than 4 sessions prior to removal of stones with ERCP.…”

Section: Discussionmentioning

confidence: 99%

Pancreatoscopy-Directed Electrohydraulic Lithotripsy for Pancreatic Ductal Stones in Painful Chronic Pancreatitis Using SpyGlass

et al. 2017

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ObjectivesPainful chronic pancreatitis (CP) is often associated with main duct obstruction due to stones.Approaches to management are challenging, including surgery, extracorporeal shock wave lithotripsy, or endoscopic approaches. Here we report our experience of pancreatoscopy + electrohydraulic lithotripsy (EHL) for pancreatic duct (PD) stones using SpyGlass. MethodsWe retrospectively audited the use of SpyGlass (Legacy & DS™) + EHL. Indication, procedural details, and clinical outcome were assessed. Results118 SpyGlass + EHL procedures for stones were performed, of which 8 (7%) for pancreatic stones, in 6 patients (3 female, mean age 45 years ±7 years). All patients had painful CP, with radiological evidence of a dilated PD, and main duct stone disease. Surgical options had been considered in all cases. Stone fragmentation and PD decompression was achieved in 83% (n=5) without complications. Two patients required two EHL procedures to achieve clearance. One patient failed clearance, pancreatoscopy revealed a stone in the adjacent parenchyme and not in PD. All patients with successful EHL had pain relief/marked improvement at clinical review (mean follow-up 2.7 ±1.1 years). ConclusionPancreatoscopy + EHL may have a valuable role in treating obstructing pancreatic ductal stones, possibly avoiding the need for surgery in some patients.

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“…P‐ESWL was first used to remove pancreatic stones in 1987 . As a safe and effective non‐invasive therapeutic modality for the treatment of pancreatic stones, P‐ESWL is now the accepted standard of care for the management of large pancreatic stones all over the world . Since P‐ESWL acts on pancreatic stones via cavitation, and shear, resulted in stone fragmentation; these forces may lead to the injury of adjacent tissues.…”

Section: Discussionmentioning

confidence: 99%

“…5 As a safe and effective non-invasive therapeutic modality for the treatment of pancreatic stones, P-ESWL is now the accepted standard of care for the management of large pancreatic stones all over the world. 1,6,7 Since P-ESWL acts on pancreatic stones via cavitation, and shear, resulted in stone fragmentation; these forces may lead to the injury of adjacent tissues. To our knowledge, bleeding after P-ESWL includes hilar hematoma, hemorrhagic pseudoaneurysm in the pancreatic pseudocyst, mesenteric hemorrhage and hepatic subcapsular hematoma.…”

Section: Journal Of Digestive Diseases 2018; 19; 314-317mentioning

confidence: 99%

Extracorporeal Shock Wave Lithotripsy for Chinese Patients With Pancreatic Stones

Abstract: Thus, ESWL is a safe and effective method to treat Chinese patients with pancreatic stones. This procedure can significantly improve the success rate of endotherapy.

Cited by 57 publications

References 38 publications

Extracorporeal shock wave lithotripsy is safe and effective for geriatric patients with chronic pancreatitis

Extracorporeal shock wave lithotripsy is safe and effective for geriatric patients with chronic pancreatitis

Pancreatoscopy-Directed Electrohydraulic Lithotripsy for Pancreatic Ductal Stones in Painful Chronic Pancreatitis Using SpyGlass

Hepatic subcapsular hematoma breaking into the abdominal cavity after extracorporeal shock wave lithotripsy for pancreatic stones

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