title: Long-term results of combined ESWL and ERCP treatment of chronic calcific pancreatitis.
abstract: OBJECTIVE
  Extracorporeal shock wave lithotripsy (ESWL) combined with endotherapy (ET) is the standard treatment for pancreatic duct stones (PDS) in chronic pancreatitis (CP). Our aim was to report the short- and long-term results of ESWL and ET.
  
  
  METHODS
  Consecutively treated 83 patients with symptomatic PDS using ESWL and ET. Success was defined (i) technically: PDS fragmentation and clearance obtained and (ii) clinically: improvement/resolution of pain. To get information on quality of life, we conducted a phone survey whereby we contacted 64 (89%) patients. The long-term results are presented in those patients with ≥2 years follow-up.
  
  
  RESULTS
  Treated PDS with median size of 10 (5-25) mm were located in the head, body, or the tail of the pancreas in 78, 4, and 1 patients, respectively. The primary results were that technical success was achieved in 69 patients (83%) and clinical success in 66 patients (80%). Fourteen patients had technical failure, but eight of them became free of pain. Thus, clinical success can be considered to have been achieved in 74 of 83 patients (89%). In patients with persistent pseudocyst (PC) at the time of ESWL (n = 19), the PC disappeared in a year in 14 patients (74%). The long-term results were obtained from 61 (73%) ESWL- and ET-treated patients. The median follow-up for them was 53 months (range: 24-124) and 57 patients (93%) became pain-free or had less pain.
  
  
  CONCLUSIONS
  For patients with CP and PDS ESWL combined with ET is an effective and safe treatment giving favorable long-term results.
authors.affiliation: a Department of Surgery , Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Taija
authors.initials: T
authors.lastname: Korpela
authors.affiliation: a Department of Surgery , Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Marianne
authors.initials: M
authors.lastname: Udd
authors.affiliation: b Department of Gastroenterology , Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Andrea
authors.initials: A
authors.lastname: Tenca
authors.affiliation: a Department of Surgery , Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Outi
authors.initials: O
authors.lastname: Lindström
authors.affiliation: a Department of Surgery , Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Jorma
authors.initials: J
authors.lastname: Halttunen
authors.affiliation: c Department of Urology , Helsinki University Hospital, University of Helsinki , Helsinki , Finland.
authors.forename: Sanna
authors.initials: S
authors.lastname: Myrskysalo
authors.affiliation: c Department of Urology , Helsinki University Hospital, University of Helsinki , Helsinki , Finland.
authors.forename: Arto
authors.initials: A
authors.lastname: Mikkola
authors.affiliation: a Department of Surgery , Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Leena
authors.initials: L
authors.lastname: Kylänpää
mesh_terms: D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000401:mortality / Q000628:therapy*; D011788:Quality of Life; D013995:Time
keywords: Endotherapy; lithotripsy; pancreatic calculi; pancreatic duct stones; shockwave