title: Long-term clinical outcomes of extracorporeal shockwave lithotripsy in painful chronic calcific pancreatitis.
abstract: BACKGROUND
  Long-term results of extracorporeal shockwave lithotripsy (ESWL) for large pancreatic duct (PD) stones in patients with idiopathic calcific pancreatitis (CP) are scanty.
  
  
  OBJECTIVE
  To evaluate intermediate and long-term results of ESWL in a large cohort of patients with idiopathic CP.
  
  
  METHODS
  Cross-sectional study; retrospective chart review.
  
  
  METHODS
  A high-volume, tertiary-care center for endoscopy and GI diseases.
  
  
  METHODS
  A total of 636 patients with idiopathic CP who underwent ESWL and ERCP were followed-up. Patients were divided into intermediate (24-60 months) and long-term (>60 months) follow-up groups.
  
  
  METHODS
  ESWL and ERCP.
  
  
  METHODS
  Improvement in pain, analgesic use, hospitalization for pain, recurrence of calculi, need for additional intervention, and quality of life.
  
  
  RESULTS
  A total of 636 of 1006 patients who underwent ESWL between 2004 and 2009 were followed for a maximum of 96 months. There were 364 patients in the intermediate follow-up group and 272 in the long-term follow-up group. After ESWL and ERCP, absence of pain was seen in 250 patients (68.7%), mild-to-moderate pain in 94 patients (25.4%), and severe pain in 20 patients (5.5%) of the intermediate group. In the long-term group, 164 patients (60.3%) had no pain, 97 patients (35.7%) had mild or moderate episodes of pain, whereas 11 patients (4.04%) had episodic severe pain. Recurrence of calculi was seen in 51 patients (14.01%) in the intermediate follow-up group and in 62 patients (22.8%) in the long-term group. Quality of life improved in a significant number of patients in both groups.
  
  
  CONCLUSIONS
  Retrospective study, single center, recall bias, and subjective pain and quality-of-life measurement scale.
  
  
  CONCLUSIONS
  ESWL for large PD calculi offers good results in patients of idiopathic CP on intermediate and long-term follow-up.
authors.affiliation: Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Manu
authors.initials: M
authors.lastname: Tandan
authors.forename: Duvvur Nageshwar
authors.initials: DN
authors.lastname: Reddy
authors.forename: Rupjyoti
authors.initials: R
authors.lastname: Talukdar
authors.forename: Koppuju
authors.initials: K
authors.lastname: Vinod
authors.forename: Darisetty
authors.initials: D
authors.lastname: Santosh
authors.forename: Sundeep
authors.initials: S
authors.lastname: Lakhtakia
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Mohan J
authors.initials: MJ
authors.lastname: Ramchandani
authors.forename: Rupa
authors.initials: R
authors.lastname: Banerjee
authors.forename: Kalapala
authors.initials: K
authors.lastname: Rakesh
authors.forename: Gokak
authors.initials: G
authors.lastname: Varadaraj
authors.forename: Guduru Venkat
authors.initials: GV
authors.lastname: Rao
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy*; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D002137:Calculi / Q000150:complications / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D020347:Lithiasis / Q000150:complications / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D010147:Pain Measurement; D010183:Pancreatic Ducts; D050500:Pancreatitis, Chronic / Q000150:complications / Q000628:therapy*; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome
chemical_list: D000700:Analgesics
keywords: CP; ESWL; Hb(A1c); MPD; MRCP; Magnetic resonance cholangiopancreatography; PD; calcific pancreatitis; extracorporeal shockwave lithotripsy; glycosylated hemoglobin; main pancreatic duct; pancreatic duct