title: [Safety and effectiveness of successive extracorporeal shock wave lithotripsy for pancreatolithiasis under intravenous bolus pethidine administration alone].
abstract: OBJECTIVE
  A retrospective analysis was performed to evaluate the safety and effectiveness of extracorporeal shock wave lithotripsy (ESWL) for pancreatolithiasis on successive days under intravenous bolus of pethidine alone.
  
  
  METHODS
  Ninety patients with calcified pancreatic stones (≥5 mm) presenting with abdominal pain were selected for ESWL. ESWL was performed with an electroconductive lithotripter under fluoroscopic target systems. Fragmented calculi after ESWL were removed by endotherapy.
  
  
  RESULTS
  A mean of 4.2 ESWL sessions were performed for each patient, with a mean of 2,984 shocks at a mean power setting of 12.8 kV. Eighty-four (89.3%) patients underwent ESWL for three or more days in a row. Fragmentation of the stones were achieved in 83/90 (92.2%) patients. Complete clearance of the main pancreatic duct was achieved in 54/90 (60.0%) patients, and partial clearance was achieved in 27 (30.0%) patients. The mean dose of pethidine used during ESWL was 53.5±20.7 mg per session. As ESWL-related complications, four (4.3%) patients developed mild acute pancreatitis.
  
  
  CONCLUSIONS
  In case of endoscopically difficult-to-treat pancreatic duct stones, combined therapy with ESWL is an effective method, and treatment with multiple sessions of ESWL on successive days under intravenous bolus of pethidine alone is safe and well tolerated.
authors.affiliation: Department of Gastroenterology, Ulsan University Hospital, Ulsan, Division of Gastroenterology, University of Ulsan College of Medicine, Korea.
authors.forename: Byung Uk
authors.initials: BU
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Joon Hyuk
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jun-Ho
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hyo Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Seo
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sung-Koo
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002137:Calculi / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007275:Injections, Intravenous; D008096:Lithotripsy; D008297:Male; D008614:Meperidine / Q000008:administration & dosage*; D008875:Middle Aged; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000628:therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D008614:Meperidine