Extracorporeal shock wave lithotripsy of pancreatic duct stones using the healthtronics lithotron lithotriptor and the dornier HM3 lithotripsy machine

Jonathan N. Rubenstein, Willis G. Parsons, Samuel C. Kim, Adam C. Weiser, Michele M. Loor, David S. Kube, Robert B. Nadler*

*Corresponding author for this work

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Purpose: Pancreatic duct stones, which are most often a result of alcohol induced chronic pancreatitis, can lead to chronic abdominal pain, pseudocysts, and exocrine and endocrine failure of the pancreas. Others have reported success using extracorporeal shock wave lithotripsy (ESWL) (Dornier Medical Systems, Inc., Marietta, Georgia) for pancreatic stones. We report our experience with pancreatic ESWL using the LithoTron (Healthtronics, Marietta, Georgia) and HM3 (Dornier) lithotripsy machines. Materials and Methods: We performed pancreatic ESWL in 23 patients in 4 years, including in 12 with the LithoTron and in 11 with the HM3. After ESWL endoscopic retrograde cholangiopancreatography (ERCP) was performed in all cases. Stone-free status was defined as no stone fragments visualized or the elimination of all post-ESWL stones by ERCP. Results: Stone-free status was documented in 83% and 82% of patients treated with the LithoTron and HM3, respectively, and 2 per group later required open surgical intervention. There were no changes in pancreatic enzymes and no cases of sepsis or fever after ERCP. Conclusions: In association with post-procedure ERCP pancreatic ESWL is an effective and safe procedure that enables patients with obstructing pancreatic duct stones recalcitrant to primary endoscopic extraction to avoid a potentially morbid open procedure. The HM3 and LithoTron have comparable efficacy and safety. This modality is particularly effective for a stone aggregate of less than 20 mm., while a larger stone burden of greater than 20 mm. in aggregate and multiple stones are clear risk factors for treatment failure.

Original languageEnglish (US)
Pages (from-to)485-487
Number of pages3
JournalJournal of Urology
Volume167
Issue number2 I
DOIs
StatePublished - Jan 1 2002

Keywords

  • Calculi
  • ESWL (extracorporeal shock wave lithotripsy)
  • Pancreas
  • Pancreatitis

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Extracorporeal shock wave lithotripsy of pancreatic duct stones using the healthtronics lithotron lithotriptor and the dornier HM3 lithotripsy machine'. Together they form a unique fingerprint.

  • Cite this