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

Wang, Dan; Bi, Yang; Ji, Jun-Tao; Xin, Lei; Liao, Zhuan; Du, Tingting; Lin, Jin‐Huan; Zhang, Di; Zeng, Xiang-Peng; Ye, Bo; Zou, Wenbin; Chen, Hui; Xie, Ting; Li, Bai-Rong; Zhang, Zheng; Li, Zhao‐Shen; Hu, Liang‐Hao

doi:10.1055/s-0043-104527

Cited by 28 publications

(23 citation statements)

References 34 publications

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“…24 The safety and efficacy of P-ESWL have been demonstrated in numerous studies, but data for geriatric patients have not been previously reported. 1,14,15,27,29 Our study is the first to report the safety and efficacy of P-ESWL in geriatrics.…”

Section: Discussionmentioning

confidence: 80%

“…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%

“…13 Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is minimally invasive, effective, and safe for the management of young adults and pediatrics with pancreatic stones. 14,15 However, the safety and efficacy of P-ESWL in geriatric patients have not been previously reported.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 80%

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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“…Once abdominal pain or other complications related to CP occurs, early treatment is indicated. Both endotherapy and surgery are effective for pancreatic stone clearance and pain relief, with complete stone clearance of > 80% [4] and complete pain relief of 77-91% [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Nomogram for Pancreatic Stone Formation in Chronic Pancreatitis over a Long-Term Course: A Cohort of 2,153 Patients

et al. 2019

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Background: Pancreatic stones are pathognomonic of chronic pancreatitis (CP). This study aimed to determine the incidence, identify risk factors, and develop a nomogram for pancreatic stones in CP patients. Methods: Patients with CP admitted to our center from January 2000 to December 2013 were enrolled. Cumulative rates of pancreatic stones after the onset of CP and after the diagnosis of CP were calculated. Patients were randomly assigned, in a 2: 1 ratio, to the training and validation cohort. Based on the training cohort, risk factors were identified through Cox proportional hazards regression model, and nomogram was developed. Internal and external validations were performed based on the training and validation cohort, respectively. Results: With a total of 2,153 CP patients, pancreatic stones were detected in 1,626 (75.5%) patients, with a median follow-up of 7.8 years. Age at the onset of CP, body mass index, smoking, diabetes mellitus, pancreatic pseudocyst, biliary stricture, severe acute pancreatitis, and type of pain were identified risk factors for pancreatic stones development. The nomogram with these 8 factors achieved good accuracy. Conclusions: The nomogram achieved an individualized prediction of pancreatic stones development in CP. It may help the management of pancreatic stones.

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“…There are many optional treatments to remove pancreatic stones, such as ERCP, P-ESWL, mechanical lithotripsy, laser lithotripsy, surgery and others. [ 12 – 17 ] Among these methods, P-ESWL is a valid and minimally invasive treatment for pancreatic stones for its effectiveness and safety. [ 3 – 6 ] Although P-ESWL is a safe and effective therapeutic modality, complications happen now and then.…”

Section: Discussionmentioning

confidence: 99%

Large mesenteric hematoma after extracorporeal shock wave lithotripsy for pancreatic stones

et al. 2018

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Rationale:Mesenteric hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones is a very rare complication which has never been reported before.Presenting concerns:We reported a case of a 36-year-old male diagnosed as chronic pancreatitis with pancreatic stones and a large pancreatic pseudocyst. He underwent 3 repeated sessions of pancreatic ESWL (P-ESWL). After the last session of P-ESWL, he complained of dizziness. Physical examination revealed a large mass in the right abdomen.Diagnosis:Emergent upper abdominal computerized tomography (CT) revealed this mass is a mesenteric hematoma with the size of 8.2 cm × 11.7 cm in the right abdominal cavity after P-ESWL and there was no sign of intestinal obstruction.Interventions:With close monitoring of vital signs, the patient received conservative treatment for several days. Dynamic abdominal ultrasound monitoring revealed the mesenteric hematoma had organized.Outcomes:Vital signs of the patient were stable after fluid transfusion. Three-month follow-up CT showed the mesenteric hematoma had absorbed completely.Lessons:Mesenteric hematoma rarely occurs after P-ESWL and it alerts us the importance of considering uncommon complications after P-ESWL. If mesenteric hematoma occurs after P-ESWL, conservative treatment could be the first choice while surgery can also be considered.

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

Cited by 28 publications

References 34 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

Risk Factors and Nomogram for Pancreatic Stone Formation in Chronic Pancreatitis over a Long-Term Course: A Cohort of 2,153 Patients

Large mesenteric hematoma after extracorporeal shock wave lithotripsy for pancreatic stones

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