Extracorporeal shock wave lithotripsy is safe and effective for pediatric patients with chronic pancreatitis

Endoscopy. 2017 May;49(5):447-455. doi: 10.1055/s-0043-104527. Epub 2017 Apr 12.

Abstract

Background and aims Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is recommended as the first-line treatment for pancreatic stones. However, how well P-ESWL performs in pediatric patients remains unclear. We aimed to evaluate the safety and efficacy of P-ESWL for pediatric patients with chronic pancreatitis. Methods This prospective observational study was conducted in patients with painful chronic pancreatitis who underwent P-ESWL. Patients aged under 18 years were included in the pediatric group; patients aged over 18 years who underwent P-ESWL in the same period were assigned to the control group. For investigation of long-term follow-up, the pediatric group were matched with patients from the control group in a 1:1 ratio. The primary outcomes were P-ESWL complications and pain relief. The secondary outcomes included: stone clearance, physical and mental health, quality of life score, and growth and developmental state. Results From March 2011 to March 2015, P-ESWL was performed in 1135 patients (72 in the pediatric group, 1063 in the control group). No significant differences were observed in the occurrence of P-ESWL complications between the two groups (11.1 % vs. 12.8 %; P = 0.68). Among the 67 pediatric patients (93.1 %) who underwent follow-up for 3.0 years (range 1.3 - 5.2), complete pain relief was achieved in 52 patients (52 /67; 77.6 %); this value was not significantly different from that of the matched controls (55 /69; 79.7 %; P = 0.94). Conclusions P-ESWL is safe and effective for pediatric patients with chronic pancreatitis. It can promote significant pain relief and stone clearance, and can benefit growth and development.

Publication types

  • Observational Study
  • Video-Audio Media

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / therapy*
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cholangiopancreatography, Endoscopic Retrograde
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Lithiasis / complications
  • Lithiasis / therapy*
  • Lithotripsy / adverse effects*
  • Male
  • Mental Health
  • Middle Aged
  • Pain Measurement
  • Pancreatitis, Chronic / etiology
  • Pancreatitis, Chronic / therapy*
  • Prospective Studies
  • Quality of Life
  • Young Adult