title: Success of Extracorporeal Shock Wave Lithotripsy in Chronic Calcific Pancreatitis Management: A Meta-Analysis and Systematic Review.
abstract: OBJECTIVE
  This is a meta-analysis and systematic review to assess the overall utility and safety of Extracorporeal shock wave lithotripsy (ESWL) in chronic calcific pancreatitis. Primary outcomes are pain relief, narcotic usage, ductal clearance, quality of life, and pancreatic exocrine and endocrine function.
  
  
  METHODS
  Studies involving ESWL in chronic calcific pancreatitis with main pancreatic duct stones greater than 5 mm and patients that failed conservative pain management were included. Fixed and random effects models were used to calculate the pooled proportions.
  
  
  RESULTS
  Initial search identified 1471 reference articles, in which 184 articles were selected and reviewed. Data were extracted from 27 studies (N = 3189) which met the inclusion criterion. The pooled proportion of patients with absence of pain at follow-up was 52.7% (95% confidence interval [95% CI], 50.85-54.56) and mild to moderate pain at follow-up was 33.43% (95% CI, 31.40-35.50). Quality of life improved in 88.21% (95% CI, 85.43-90.73) and complete ductal clearance was 70.69% (95% CI, 68.97-72.38) in the pooled patients.
  
  
  CONCLUSIONS
  The ESWL is an effective and safe management option in patients with chronic calcific pancreatitis patients with main pancreatic duct stone size greater than 5 mm who did not get adequate pain relief with conservative management.
authors.affiliation: From the *Division of General Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL; †Division of Gastroenterology and Hepatology, University of Missouri-Columbia, Columbia, MO; ‡Interventional Endoscopy Services, Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA; §Division of Pulmonary Medicine, Department of Medicine, Saint Francis Medical Center, Peoria, IL; and ∥Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL.
authors.forename: Harsha
authors.initials: H
authors.lastname: Moole
authors.forename: Amy
authors.initials: A
authors.lastname: Jaeger
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bechtold
authors.forename: David
authors.initials: D
authors.lastname: Forcione
authors.forename: Deepak
authors.initials: D
authors.lastname: Taneja
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Puli
mesh_terms: D002114:Calcinosis / Q000150:complications / Q000628:therapy*; D002137:Calculi / Q000150:complications / Q000628:therapy; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010183:Pancreatic Ducts / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000628:therapy*; D011788:Quality of Life