Document Detail


Pancreatic duct stones in chronic pancreatitis: criteria for treatment intensity and success.
MedLine Citation:
PMID:  12297764     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of the study was to evaluate interventional endoscopic management of pancreatic duct stones in patients with chronic pancreatitis by describing therapeutic methods and defining factors that predict technical success. METHODS: Records were retrospectively analyzed for 125 patients with symptoms caused by chronic pancreatitis with pancreatic duct stones (single 43, multiple 82) treated by interventional endoscopy, including extracorporeal shockwave lithotripsy. RESULTS: Technical success was achieved in 85% of patients (11 patients by mechanical lithotripsy, 114 by piezoelectric extracorporeal shockwave lithotripsy). There were no serious complications from lithotripsy. Univariate analysis disclosed a statistically significant association between treatment success and patient age as well as prepapillary location of stones. A greater therapeutic effort was necessary in patients with stones located in the tail of the pancreas, 2 or more stones, a stone 12 mm or more in diameter, or who have had a longer duration (>8 years) of the disease. However, with exception of the last parameter, correction for multiple testing of data removed statistical significance. CONCLUSIONS: Extracorporeal shockwave lithotripsy enhances endoscopic measures for treatment of pancreatic duct stones when mechanical lithotripsy fails. Middle-aged patients in the early stages of chronic pancreatitis with stones in a prepapillary location proved to be the best candidates for successful treatment. Unfavorable patient-related or morphologic factors can be compensated for through more intense efforts at therapy.
Authors:
Michael J Farnbacher; Christoph Schoen; Thomas Rabenstein; Johannes Benninger; Eckhart G Hahn; H Thomas Schneider
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  56     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-25     Completed Date:  2002-12-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  501-6     Citation Subset:  IM    
Affiliation:
Department of Medicine I, Friedrich-Alexander-University Erlangen-Nuremberg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Calculi / complications,  radiography,  surgery*
Cholangiopancreatography, Endoscopic Retrograde / methods
Chronic Disease
Female
Humans
Lithotripsy / methods*
Male
Middle Aged
Pancreatic Diseases / complications,  radiography,  surgery*
Pancreatic Ducts / radiography
Pancreatitis / etiology,  surgery*
Prognosis
Retreatment
Retrospective Studies
Risk Factors
Sphincterotomy, Endoscopic
Stents
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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