title: Evaluation of pancreatic damage after extracorporeal shock wave lithotripsy, percutaneous stone surgery, and ureteroscopy.
abstract: OBJECTIVE
  To complete a prospective evaluation of serum amylase and lipase levels before and after shock wave lithotripsy (SWL) for renal stones. We also compared these serum levels to those of patients undergoing percutaneous and ureteroscopic stone surgery. SWL injury to the pancreas should be noted by an increase in serum amylase and lipase.
  
  
  METHODS
  A prospective evaluation of 38 patients (16 who underwent SWL, 15 who underwent percutaneous nephrostolithotomy, and 7 who underwent ureteroscopic stone manipulation) who underwent treatment of renal calculi at our institution was completed. The control group was the combined group of patients who had undergone percutaneous nephrostolithotomy or ureteroscopic stone manipulation. The serum amylase and lipase levels were measured before the procedure, immediately after the procedure (2 hours), and ≥30 days after the procedure.
  
  
  RESULTS
  No statistically significant difference was found in the change from before to immediately after the procedure between the SWL group and the controls in amylase (median decrease 6 U/L vs 11 U/L, P = .45) or lipase (median decrease 4 U/L vs 9 U/L, P = .31). Also, no statistically significant evidence was seen in the change from before to >30 days after the procedure between the SWL group and controls in the amylase level (median increase 0 U/L vs 2 U/L, P = 1.00) or lipase (median change 2 U/L increase vs 1 U/L decrease, P = .96).
  
  
  CONCLUSIONS
  SWL does not appear to noticeably increase the serum amylase and lipase level directly postoperatively or >30 days after the procedure compared with baseline or compared with the controls.
authors.affiliation: Department of Urology, Mayo Clinic Jacksonville, Jacksonville, Florida 32224, USA. Thiel.David@mayo.edu
authors.forename: David D
authors.initials: DD
authors.lastname: Thiel
authors.forename: Theodore E
authors.initials: TE
authors.lastname: Brisson
authors.forename: Michael G
authors.initials: MG
authors.lastname: Heckman
authors.forename: Michelle
authors.initials: M
authors.lastname: Arnold
authors.forename: William
authors.initials: W
authors.lastname: Haley
authors.forename: Jay
authors.initials: J
authors.lastname: Khambhati
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wehle
authors.forename: Todd C
authors.initials: TC
authors.lastname: Igel
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Parker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications* / Q000628:therapy*; D008049:Lipase / Q000097:blood; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D010179:Pancreas / Q000293:injuries / Q000473:pathology*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000009:adverse effects*
chemical_list: D008049:Lipase; D000681:Amylases