Effect and safety of pancreatic extracorporeal shock wave lithotripsy in chronic pancreatitis with pancreatic duct stone and analysis of influencing factors of the success of lithotripsy
10.3760/cma.j.cn113884-20241016-00304
- VernacularTitle:胰腺体外震波碎石治疗慢性胰腺炎合并主胰管结石的疗效、安全性分析以及碎石成功影响因素分析
- Author:
Xiang AO
1
;
Yaya BAI
1
;
Ke QI
1
;
Taojing RAN
1
;
Xiaonan SHEN
1
;
Xianzheng QIN
1
;
Yao ZHANG
1
;
Ling ZHANG
1
;
Chunhua ZHOU
1
;
Duowu ZOU
1
Author Information
1. 上海交通大学医学院附属瑞金医院消化内科/消化内镜中心，上海 200025
- Publication Type:Journal Article
- Keywords:
Pancreatitis, chronic;
Calculi;
Lithotripsy;
Treatment outcome
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(3):172-176
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect and safety of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) in treating the chronic pancreatitis (CP) patients with main pancreatic duct (MPD) stones and to analyze the influencing factors of success of lithotripsy.Methods:Clinical data of 132 patients with CP complicated with MPD stones treated with P-ESWL in the Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to December 2023 were retrospectively analyzed, including 103 males and 29 females, aged (50.3±16.9) years. The times of P-ESWL, the success rate of stone fragmentation, the necessity of combining endoscopic retrograde cholangiopancreatograhy (ERCP), clearance rate of MPD stones, and incidence of post-P-ESWL complications (acute pancreatitis, abdominal hematoma, infection, steinstrasse, perforation, etc.) were evaluated. The factors influencing the success rate of lithotripsy were analyzed using univariate and multivariate logistic regression.Results:All patients underwent P-ESWL treatment, with (2.23±0.82) times of P-ESWL per person. The success rate of stone fragmentation was 87.1%(115/132). Of 107 CP patients (81.1%, 107/132) were treated with their first P-ESWL. Of 12 patients (9.1%, 12/132) underwent single P-ESWL, and 120 (90.9%, 120/132) underwent P-ESWL combined with ERCP. There were 95 cases (72.0%, 95/132) with effective removal of stones, and 62 (47.0%, 62/132) with complete removal of stones. Post-P-ESWL complications included eight cases (6.1%, 8/132) of acute pancreatitis, two (7.6%, 2/132) of steinstrasse complicated with acute pancreatitis and one (0.8%, 1/132) of abdominal hematoma. No infection or perforation occurred. Multivariate logistic regression analysis showed that the higher CT value of stones ( OR=1.239, 95% CI: 1.040-1.477, P=0.017) was associated with the lower success rate of stone fragmentation. Conclusion:P-ESWL is safe and effective in treating patients with CP complicated with MPD stones. The CT value of stones is a risk factor for the success rate of P-ESWL.
