Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi-a large single center experience.
Indian J Gastroenterol
; 29(4): 143-8, 2010 Jul.
Article
in En
| MEDLINE
| ID: mdl-20717860
AIM: Large pancreatic ductal calculi and pain are a feature of chronic calcific pancreatitis (CCP) in the tropics. This large single center study evaluates the role of extracorporeal shock wave lithotripsy (ESWL) in fragmentation of large pancreatic stones and relief of pain in patients with CCP. METHODS: Patients with CCP presenting with pain and large pancreatic duct (PD) calculi (>5 mm diameter) not amenable to extraction at routine endoscopic retrograde cholangio pancreatography (ERCP) were taken up for ESWL using a 3rd generation lithotripter. Stones in the head and body of pancreas were targeted at ESWL; 5,000 shocks were given per session. The calculi were fragmented to <3 mm size and then cleared by endotherapy. Pancreatic duct stents were deployed when indicated. A total of 1,006 patients underwent ESWL. Complete clearance was achieved in 762 (76%), partial clearance in 173 (17%) and unsuccessful in the rest. More than 962 (90%) of patients needed less than three sessions of ESWL. At 6 months, 711 (84%) of 846 patients who returned for follow up had significant relief of pain with a decrease in analgesic use. Complications were mild and minimal. CONCLUSION: ESWL is an effective and safe modality for fragmentation of large PD calculi in patients with CCP.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatic Diseases
/
Pancreatic Ducts
/
Lithotripsy
/
Calculi
/
Cholangiopancreatography, Endoscopic Retrograde
/
Pancreatitis, Chronic
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Indian J Gastroenterol
Journal subject:
GASTROENTEROLOGIA
Year:
2010
Document type:
Article
Affiliation country:
India
Country of publication:
India