Abstract
Extracorporeal shock wave lithotripsy of pancreatic duct stones (largest stone 12 (SD) 6 mm) was performed in 24 patients with abdominal pain and a dilated duct system (main pancreatic duct 10 (3) mm). The procedure was well tolerated in all but two patients, who had a mild pancreatitic attack immediately after lithotripsy. Disintegration of the stones was achieved in 21 patients. This allowed complete clearance of the duct system by an endoscopic approach in 10 (42%) patients and partial clearance in 7 (29%) patients. Within a mean follow up period of 24 (14) months half of the patients showed complete or considerable relief of pain and alleviation of symptoms was achieved in seven patients. Relief of pain occurred more often after complete ductal clearance. There were no fatalities within the follow up period. These findings underline the value of a combined non-surgical approach, using endoscopy and adjuvant shock wave lithotripsy to patients with large pancreatic calculi and pain attacks.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ammann R. W., Akovbiantz A., Largiader F., Schueler G. Course and outcome of chronic pancreatitis. Longitudinal study of a mixed medical-surgical series of 245 patients. Gastroenterology. 1984 May;86(5 Pt 1):820–828. [PubMed] [Google Scholar]
- Axon A. T., Classen M., Cotton P. B., Cremer M., Freeny P. C., Lees W. R. Pancreatography in chronic pancreatitis: international definitions. Gut. 1984 Oct;25(10):1107–1112. doi: 10.1136/gut.25.10.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bockman D. E., Buchler M., Malfertheiner P., Beger H. G. Analysis of nerves in chronic pancreatitis. Gastroenterology. 1988 Jun;94(6):1459–1469. doi: 10.1016/0016-5085(88)90687-7. [DOI] [PubMed] [Google Scholar]
- Chaussy C., Brendel W., Schmiedt E. Extracorporeally induced destruction of kidney stones by shock waves. Lancet. 1980 Dec 13;2(8207):1265–1268. doi: 10.1016/s0140-6736(80)92335-1. [DOI] [PubMed] [Google Scholar]
- Cremer M., Devière J., Delhaye M., Baize M., Vandermeeren A. Stenting in severe chronic pancreatitis: results of medium-term follow-up in seventy-six patients. Endoscopy. 1991 May;23(3):171–176. doi: 10.1055/s-2007-1010649. [DOI] [PubMed] [Google Scholar]
- Delhaye M., Vandermeeren A., Baize M., Cremer M. Extracorporeal shock-wave lithotripsy of pancreatic calculi. Gastroenterology. 1992 Feb;102(2):610–620. doi: 10.1016/0016-5085(92)90110-k. [DOI] [PubMed] [Google Scholar]
- Devière J., Devaere S., Baize M., Cremer M. Endoscopic biliary drainage in chronic pancreatitis. Gastrointest Endosc. 1990 Mar-Apr;36(2):96–100. doi: 10.1016/s0016-5107(90)70959-5. [DOI] [PubMed] [Google Scholar]
- Ebbehøj N., Borly L., Bülow J., Rasmussen S. G., Madsen P. Evaluation of pancreatic tissue fluid pressure and pain in chronic pancreatitis. A longitudinal study. Scand J Gastroenterol. 1990 May;25(5):462–466. doi: 10.3109/00365529009095516. [DOI] [PubMed] [Google Scholar]
- Fuji T., Amano H., Harima K., Aibe T., Asagami F., Kinukawa K., Ariyama S., Takemoto T. Pancreatic sphincterotomy and pancreatic endoprosthesis. Endoscopy. 1985 Mar;17(2):69–72. doi: 10.1055/s-2007-1018460. [DOI] [PubMed] [Google Scholar]
- Greenlee H. B., Prinz R. A., Aranha G. V. Long-term results of side-to-side pancreaticojejunostomy. World J Surg. 1990 Jan-Feb;14(1):70–76. doi: 10.1007/BF01670548. [DOI] [PubMed] [Google Scholar]
- Huibregtse K., Schneider B., Vrij A. A., Tytgat G. N. Endoscopic pancreatic drainage in chronic pancreatitis. Gastrointest Endosc. 1988 Jan-Feb;34(1):9–15. doi: 10.1016/s0016-5107(88)71221-3. [DOI] [PubMed] [Google Scholar]
- Ihse I., Borch K., Larsson J. Chronic pancreatitis: results of operations for relief of pain. World J Surg. 1990 Jan-Feb;14(1):53–58. doi: 10.1007/BF01670546. [DOI] [PubMed] [Google Scholar]
- Malfertheiner P., Büchler M. Indications for endoscopic or surgical therapy in chronic pancreatitis. Endoscopy. 1991 May;23(3):185–190. doi: 10.1055/s-2007-1010652. [DOI] [PubMed] [Google Scholar]
- Neuhaus H. Fragmentation of pancreatic stones by extracorporeal shock wave lithotripsy. Endoscopy. 1991 May;23(3):161–165. doi: 10.1055/s-2007-1010647. [DOI] [PubMed] [Google Scholar]
- Sackmann M., Pauletzki J., Sauerbruch T., Holl J., Schelling G., Paumgartner G. The Munich Gallbladder Lithotripsy Study. Results of the first 5 years with 711 patients. Ann Intern Med. 1991 Feb 15;114(4):290–296. doi: 10.7326/0003-4819-114-4-290. [DOI] [PubMed] [Google Scholar]
- Sarles H. Chronic calcifying pancreatitis. Scand J Gastroenterol. 1985 Aug;20(6):651–659. doi: 10.3109/00365528509089190. [DOI] [PubMed] [Google Scholar]
- Sauerbruch T., Delius M., Paumgartner G., Holl J., Wess O., Weber W., Hepp W., Brendel W. Fragmentation of gallstones by extracorporeal shock waves. N Engl J Med. 1986 Mar 27;314(13):818–822. doi: 10.1056/NEJM198603273141304. [DOI] [PubMed] [Google Scholar]
- Sauerbruch T., Holl J., Sackmann M., Paumgartner G. Extracorporeal shock wave lithotripsy of pancreatic stones. Gut. 1989 Oct;30(10):1406–1411. doi: 10.1136/gut.30.10.1406. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sauerbruch T., Holl J., Sackmann M., Werner R., Wotzka R., Paumgartner G. Disintegration of a pancreatic duct stone with extracorporeal shock waves in a patient with chronic pancreatitis. Endoscopy. 1987 Sep;19(5):207–208. doi: 10.1055/s-2007-1018284. [DOI] [PubMed] [Google Scholar]
- Sauerbruch T., Stern M. Fragmentation of bile duct stones by extracorporeal shock waves. A new approach to biliary calculi after failure of routine endoscopic measures. Gastroenterology. 1989 Jan;96(1):146–152. doi: 10.1016/0016-5085(89)90775-0. [DOI] [PubMed] [Google Scholar]
- Widdison A. L., Alvarez C., Karanjia N. D., Reber H. A. Experimental evidence of beneficial effects of ductal decompression in chronic pancreatitis. Endoscopy. 1991 May;23(3):151–154. doi: 10.1055/s-2007-1010645. [DOI] [PubMed] [Google Scholar]