Long-term clinical outcomes of extracorporeal shockwave lithotripsy in painful chronic calcific pancreatitis

详细信息    查看全文

• 作者：Manu T ; an ; Duvvur Nageshwar Reddy ; Rupjyoti Talukdar ; Koppuju Vinod ; Darisetty Santosh ; Sundeep Lakhtakia ; Rajesh Gupta ; Mohan J. Ramch ; ani ; Rupa Banerjee ; Kalapala Rakesh ; Gokak Varadaraj ; Guduru Venkat Rao
• 关键词：CP ; calcific pancreatitis ; ESWL ; extracorporeal shockwave lithotripsy ; HbA1c ; glycosylated hemoglobin ; MPD ; main pancreatic duct ; PD ; pancreatic duct ; MRCP ; Magnetic resonance cholangiopancreatography
• 刊名：Gastrointestinal Endoscopy
• 出版年：2013
• 出版时间：November, 2013
• 年：2013
• 卷：78
• 期：5
• 页码：726-733
• 全文大小：448 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Background

Long-term results of extracorporeal shockwave lithotripsy (ESWL) for large pancreatic duct (PD) stones in patients with idiopathic calcific pancreatitis (CP) are scanty.

Objective

To evaluate intermediate and long-term results of ESWL in a large cohort of patients with idiopathic CP.

Design

Cross-sectional study; retrospective chart review.

Setting

A high-volume, tertiary-care center for endoscopy and GI diseases.

Patients

A total of 636 patients with idiopathic CP who underwent ESWL and ERCP were followed-up. Patients were divided into intermediate (24-60 months) and long-term (>60 months) follow-up groups.

Intervention

ESWL and ERCP.

Main Outcome Measurements

Improvement in pain, analgesic use, hospitalization for pain, recurrence of calculi, need for additional intervention, and quality of life.

Results

A total of 636 of 1006 patients who underwent ESWL between 2004 and 2009 were followed for a maximum of 96 months. There were 364 patients in the intermediate follow-up group and 272 in the long-term follow-up group. After ESWL and ERCP, absence of pain was seen in 250 patients (68.7 % ), mild-to-moderate pain in 94 patients (25.4 % ), and severe pain in 20 patients (5.5 % ) of the intermediate group. In the long-term group, 164 patients (60.3 % ) had no pain, 97 patients (35.7 % ) had mild or moderate episodes of pain, whereas 11 patients (4.04 % ) had episodic severe pain. Recurrence of calculi was seen in 51 patients (14.01 % ) in the intermediate follow-up group and in 62 patients (22.8 % ) in the long-term group. Quality of life improved in a significant number of patients in both groups.

Limitations

Retrospective study, single center, recall bias, and subjective pain and quality-of-life measurement scale.

Conclusion

ESWL for large PD calculi offers good results in patients of idiopathic CP on intermediate and long-term follow-up.