Long-term results of combined ESWL and ERCP treatment of chronic calcific pancreatitis. (2nd July 2016)

• Record Type: Journal Article
• Authors: Korpela, Taija; Udd, Marianne; Tenca, Andrea; Lindström, Outi; Halttunen, Jorma; Myrskysalo, Sanna; Mikkola, Arto; Kylänpää, Leena
• Is Part Of: Scandinavian journal of gastroenterology. Volume 51:Number 7(2016)
• Page Start: 866
• Page End: 871
• Publication Date: 2016-07-02
• Subjects: Endotherapy -- lithotripsy -- pancreatic calculi -- pancreatic duct stones -- shockwave; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2016.1150502
• Languages: English
• ISSNs: 0036-5521

Abstract

ABSTRACT: Objective: Extracorporeal shock wave lithotripsy (ESWL) combined with endotherapy (ET) is the standard treatment for pancreatic duct stones (PDS) in chronic pancreatitis (CP). Our aim was to report the short- and long-term results of ESWL and ET. Material and methods: Consecutively treated 83 patients with symptomatic PDS using ESWL and ET. Success was defined (i) technically: PDS fragmentation and clearance obtained and (ii) clinically: improvement/resolution of pain. To get information on quality of life, we conducted a phone survey whereby we contacted 64 (89%) patients. The long-term results are presented in those patients with ≥2 years follow-up. Results: Treated PDS with median size of 10 (5–25) mm were located in the head, body, or the tail of the pancreas in 78, 4, and 1 patients, respectively. The primary results were that technical success was achieved in 69 patients (83%) and clinical success in 66 patients (80%). Fourteen patients had technical failure, but eight of them became free of pain. Thus, clinical success can be considered to have been achieved in 74 of 83 patients (89%). In patients with persistent pseudocyst (PC) at the time of ESWL ( n = 19), the PC disappeared in a year in 14 patients (74%). The long-term results were obtained from 61 (73%) ESWL- and ET-treated patients. The median follow-up for them was 53 months (range: 24–124) and 57 patients (93%) became pain-free or had less pain. Conclusions: For patients with CP and PDS ESWL combined with ET is an effective and safe treatment giving favorable long-term results.