Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi—a large single center experience.
Loading...
Date
2010-07
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
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.
Description
Keywords
Chronic calcific pancreatitis, Endoscopic retrograde pancreatography, Large pancreatic calculi, Tropical calcific pancreatitis
Citation
Tandan Manu, Reddy Duvvuru Nageshwar, Santosh Darisetty, Vinod Koppoju, Ramchandani Mohan, Rajesh Gupta, Rama Kotla, Lakhtakia Sandeep, Banerjee Rupa, Pratap Nitesh, Rao Guduru Venkat. Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi—a large single center experience. Indian Journal of Gastroenterology. 2010 Jul-Aug; 29(4): 143-148.