Hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones

Hirata, Nobuto; Kushida, Yona; Ohguri, Takehiko; Wakasugi, Satoshi; Kojima, Toshihiro; Fujita, Rikiya

doi:10.1007/s005350050325

Cited by 31 publications

(14 citation statements)

References 16 publications

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“…A decrease in the use of analgesics and hospitalization has been reported earlier [18]. Though a wide range of complications have been reported with ESWL [25][26][27], these were minimal in this series and there was no mortality. The use of epidural anesthesia and sharp focusing achieved with the 3rd generation lithotripter decreases collateral tissue damage and reduces the rate of complications.…”

Section: Discussionmentioning

confidence: 67%

Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi—a large single center experience

Tandan

Reddy

Darisetty

et al. 2010

Indian J Gastroenterol

114

105

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Section: Discussionmentioning

confidence: 67%

Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi—a large single center experience

Tandan

Reddy

Darisetty

et al. 2010

Indian J Gastroenterol

114

105

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“…A number of rare and serious complications have been reported following ESWL[28-31]. These include perirenal hematoma, biliary obstruction, bowel perforation, splenic rupture, lung trauma and necrotizing pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Outcome of a session of extracorporeal shock wave lithotripsy before endoscopic retrograde cholangiopancreatography for problematic and large common bile duct stones

Tao

Zhang

et al. 2017

WJG

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AIMTo compare the efficacy of a session of extracorporeal shock wave lithotripsy (ESWL) before endoscopic retrograde cholangiopancreatography (ERCP) vs ERCP only for problematic and large common bile duct (CBD) stones.METHODSAdult patients with CBD stones for whom initial ERCP was unsuccessful because of the large size of CBD stones were identiﬁed. The patients were randomized into two groups, an “ESWL + ERCP group” and an “ERCP-only” group. For ESWL + ERCP cases, ESWL was performed prior to ERCP. Clearance of the CBD, complications related to the ESWL/ERCP procedure, frequency of mechanical lithotripsy use and duration of the ERCP procedure were evaluated in both groups.RESULTSThere was no significant difference in baseline characteristics between the two groups. A session of ESWL before ERCP compared with ERCP only resulted in similar outcomes in terms of successful stone removal within the first treatment session (74.2% vs 71.0%, P = 0.135), but a higher clearance rate within the second treatment session (84.4% vs 51.6%, P = 0.018) and total stone clearance (96.0% vs 86.0%, P = 0.029). Moreover, ESWL prior to ERCP not only reduced ERCP procedure time (43 ± 21 min vs 59 ± 28 min, P = 0.034) and the rate of mechanical lithotripsy use (20% vs 30%, P = 0.025), but also raised the clearance rate of extremely large stones (80.0% vs 40.0%, P = 0.016). Post-ERCP complications were similar for the two groups.CONCLUSIONBased on the higher rate of successful stone removal and minimal complications, ESWL prior to ERCP appears to be a safe and effective treatment for the endoscopic removal of problematic and large CBD stones.

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“…A few serious and rare compilations have also been described following ESWL. These include perirenal hematoma, biliary obstruction, splenic rupture, bowel perforation, liver trauma as well as necrotising pancreatitis 38–41. However these complications are few and occur infrequently.…”

Section: Modalities Of Treatmentmentioning

confidence: 99%

Management of Pancreatic Calculi: An Update

2016

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Pancreatolithiasis, or pancreatic calculi (PC), is a sequel of chronic pancreatitis (CP) and may occur in the main ducts, side branches or parenchyma. Calculi are the end result, irrespective of the etiology of CP. PC contains an inner nidus surrounded by successive layers of calcium carbonate. These calculi obstruct the pancreatic ducts and produce ductal hypertension, which leads to pain, the cardinal feature of CP. Both endoscopic therapy and surgery aim to clear these calculi and decrease ductal hypertension. In small PC, endoscopic retrograde cholangiopancreatography (ERCP) followed by sphincterotomy and extraction is the treatment of choice. Large calculi require fragmentation by extracorporeal shock wave lithotripsy (ESWL) prior to their extraction or spontaneous expulsion. In properly selected cases, ESWL followed by ERCP is the standard of care for the management of large PC. Long-term outcomes following ESWL have demonstrated good pain relief in approximately 60% of patients. However, ESWL has limitations. Per oral pancreatoscopy and intraductal lithotripsy represent techniques in evolution, and in current practice their use is limited to centers with considerable expertise. Surgery should be offered to all patients with extensive PC, associated multiple ductal strictures or following failed endotherapy.

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Hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones

Cited by 31 publications

References 16 publications

Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi—a large single center experience

Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi—a large single center experience

Outcome of a session of extracorporeal shock wave lithotripsy before endoscopic retrograde cholangiopancreatography for problematic and large common bile duct stones

Management of Pancreatic Calculi: An Update

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