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

Li, Bai-Rong; Liao, Zhuan; Du, Tingting; Ye, Bo; Chen, Hui; Ji, Jun-Tao; Zhang, Zheng; Hao, Junfeng; Ning, Shou-Bin; Wang, Dan; Lin, Jin‐Huan; Hu, Liang‐Hao; Li, Zhao‐Shen

doi:10.1016/j.gie.2015.10.026

Cited by 55 publications

(40 citation statements)

References 28 publications

(54 reference statements)

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“…Throughout these past years, it has benefited lots of studies on CP. 19,[21][22][23][24][25] The Changhai CP Database (version number 2.1, Yinma Information Technology Inc., Shanghai, China) was established to collect the clinical data of CP patients who were admitted to Changhai Hospital since 2005. Data from January 2000 to December 2004 were collected according to the electronic medical record system retrospectively and were complemented through telephone, letter, and email inquiries.…”

Section: Methodsmentioning

confidence: 99%

Risk factors and nomogram for diabetes mellitus in idiopathic chronic pancreatitis

Liu

Wang

Guo

et al. 2019

J of Gastro and Hepatol

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Background and Aim Diabetes mellitus (DM) is a common complication of idiopathic chronic pancreatitis (ICP), which impairs the quality of life for patients. This study aimed to identify risk factors and develop nomogram for DM in ICP to help early diagnosis. Methods Idiopathic chronic pancreatitis patients admitted to our center from January 2000 to December 2013 were included. Cumulative rates of DM were calculated by Kaplan–Meier method. Patients were randomly assigned, in a 2:1 ratio, to the training and validation cohort. Based on training cohort, risk factors for DM 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 Totally, 1633 patients with ICP were finally enrolled. The median follow‐up duration was 9.8 years. DM was found in 26.3% (430/1633) of patients after the onset of CP. Adult at onset of ICP, biliary stricture at/before diagnosis of CP, steatorrhea at/before diagnosis of CP, and complex pathologic changes in main pancreatic duct were identified risk factors for DM development. The nomogram achieved good concordance indexes in the training and validation cohorts, respectively, with well‐fitted calibration curves. Conclusions Risk factors were identified, and nomogram was developed to determine the risk of DM in ICP patients. Patients with one or more of the risk factors including adult at onset of ICP, biliary stricture at/before diagnosis of CP, steatorrhea at/before diagnosis of CP, and complex pathologic changes in main pancreatic duct have higher incidence of DM.

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Section: Methodsmentioning

confidence: 99%

Risk factors and nomogram for diabetes mellitus in idiopathic chronic pancreatitis

Liu

Wang

Guo

et al. 2019

J of Gastro and Hepatol

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“…We evaluated the location of stones with respect to pancreatic region (head, body, or tail), as well as with respect to the pancreatic duct (in the main pancreatic duct [MPD] or in side branches) [14]. We also assessed the size and number of stones during the study period [25]. Biliary stricture was defined as a narrowing of the CBD with prestenosis dilation > 1 cm on MRI, CT, or ultrasound or delayed runoff of contrast on ERCP [26].…”

Section: Definitionsmentioning

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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“…ESWL/ERCP and surgery are effective and, with low rates of severe adverse events, are preferred methods and have been recommended as first-line treatment for stone clearance. [2][3][4][5][6][7] Third, intraductal LL cannot be performed when there is unsuccessful cannulation of the guidewire. Instead, in such circumstances, through ESWL combined with ERCP, successful endoscopic decompression was achieved in 84.6% of the patients with failed ERCP before ESWL.…”

Section: Laser Lithotripsy As a Supplementary Approach For The Treatmmentioning

confidence: 99%

Laser lithotripsy as a supplementary approach for the treatment of main pancreatic duct stones

2016

Gastrointestinal Endoscopy

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ESD has been systematically used to treat colorectal neoplasms for which EMR is predictably difficult because of large size, unfavorable Paris classification, or predicted submucosal invasion. 2,3 For example, differences in lesion characteristics from the large multicenter Japanese experience published by Nakajima et al 4 and depicted in Table 1 are reasonably representative of the colorectal ESD literature in general.Clearly, context is needed to interpret the fact that 7.6% of ESD patients needed further surgery as compared with 4% of EMR patients in this series. It is worth noting that essentially all patients who require further surgery after colorectal ESD have incompletely resected submucosal cancers, often because of more-extensive submucosal involvement than was predicted based on Paris classification and pit pattern evaluation using magnification chromoendoscopy. 4,5 If approximately 50% of patients require surgery after ESD of a submucosal colorectal cancer, 4,6 this is more of an indictment of the lesion selection process rather than of the therapeutic technique. Furthermore, the 50% of patients with submucosal cancers in whom a curative resection is attained with ESD may be spared surgery, a benefit that EMR can rarely offer this patient group. Because lateral margins cannot be assessed with EMR and assessment of deep margins and lymph/ vascular invasion may be hindered, piecemeal resections of malignant polyps cannot be categorized as curative. 3 This fact is reinforced by the relatively high local recurrence rate of 12.2% after EMR, compared with the low recurrence rate of .9% after ESD reported in a recent colorectal ESD meta-analysis. 5 Of note, a proportion of those patients with a local recurrence will also require further surgery.As our status evaluation report highlights, randomized controlled trials comparing ESD with competing procedures, including EMR and surgical interventions, are much needed. Also needed are additional outcomes data from Western endoscopists.

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

Abstract: In 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.

Cited by 55 publications

References 28 publications

Risk factors and nomogram for diabetes mellitus in idiopathic chronic pancreatitis

Risk factors and nomogram for diabetes mellitus in idiopathic chronic pancreatitis

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

Laser lithotripsy as a supplementary approach for the treatment of main pancreatic duct stones

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