Extracorporeal shock wave lithotripsy for pancreatic duct stones: an observational study.
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Author
Haraldsson, StefanRoug, Stine
Nøjgaard, Camilla
Novovic, Srdan
Gluud, Lise Lotte
Feldager, Erik
Schmidt, Palle Nordblad
中国基督教
Keyword
Chronic pancreatitisabdominal pain
analgesia
extracorporeal shock wave lithotripsy
pancreatic duct stones
PubMed ID
30353766
Metadata
Show full item recordAbstract
Previous studies suggest that fragmentation of pancreatic duct stones (PDS) using extracorporeal shock wave lithotripsy (ESWL) is associated with pain relief. However, the treatment may not be effective in certain subgroups. To evaluate predictors of pain relief after ESWL in patients with chronic pancreatitis and PDS. Retrospective study including patients with chronic pancreatitis undergoing ESWL for painful PDS. Analgesic use before and after the ESWL procedure was registered. We defined adequate pain relief after ESWL as 'pain-free without analgesics or with use of weak analgesics as needed'. The study was approved by the Danish Data Protection Agency (approval number: AHH-2017-048). We included 81 patients (median age 58 years; 63% men; 68% alcoholic pancreatitis). Patients underwent one to seven ESWL procedures (mean 1.7). A concurrent ERCP was performed in 17%. All patients used analgesics before the ESWL procedure (68 used opioids). After ESWL, 43 still used opioids. Thirty-two patients achieved adequate pain relief. Univariable regression analysis showed that older age predicted adequate pain relief (OR 1.09;1.03-1.16; p = .002) as did location of the stone in the head or neck (OR 2.59;1.04-6.45; p = .041). In multivariable analysis, we found that the only two predictors of adequate pain relief were age (p = .002) and the location of the stones (p = .039).DOI
10.1080/00365521.2018.1508611ae974a485f413a2113503eed53cd6c53
10.1080/00365521.2018.1508611
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