Long-term outcomes associated with pancreatic extracorporeal shock wave lithotripsy for chronic calcific pancreatitis

Background Most outcomes data on pancreatic extracorporeal shock wave lithotripsy (P-ESWL) for chronic calcific pancreatitis (CCP) are based on studies with Objective To report long-term P-ESWL outcomes for CCP and to assess whether smoking or alcohol use influences P-ESWL outcomes. Design Cross-sectional study, retrospective chart review. Setting Virginia Mason Medical Center, Seattle, Washington. Patients This study involved 120 patients who underwent P-ESWL and ERCP for CCP and completed an outcomes questionnaire. Intervention P-ESWL and ERCP, outcomes survey. Main Outcome Measurements Pain, quality of life, narcotics use, diabetes status, pancreatic enzyme requirement, repeat P-ESWL, repeat ERCP, surgery. Results A total of 120 patients underwent P-ESWL followed by ERCP (mean ± standard deviation [SD] follow-up 4.3 [± 3.7] years) and completed a survey. The mean (± SD) before-P-ESWL pain score was 7.9 (± 2.6) compared with 2.9 (± 2.6) after P-ESWL ( P P P = .014), and a trend suggested a decreased need for repeat ERCPs (68% vs 84%; P = .071). Limitations Single center, retrospective, recall bias, nonvalidated pain and quality-of-life scales. Conclusion P-ESWL as the initial therapy for CCP may lead to more lifetime procedures; however, partial pain relief in 85%, complete pain relief with no narcotic use in 50%, and avoidance of surgery in 84% of patients may be achieved. Quitting smoking after P-ESWL may improve outcomes.