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Shock Wave Lithotripsy Effective for Pancreatitis Pain

No added benefit seen from combining shock wave lithotripsy with endoscopy

WEDNESDAY, April 18 (HealthDay News) -- Treatment with extracorporeal shock wave lithotripsy is safe and effective in select patients with painful, chronic pancreatitis, but combining the treatment with endoscopy does not further reduce pain and is more expensive, according to a study in the April issue of Gut.

Jean-Marc Dumonceau, M.D., of Geneva University Hospitals in Geneva, Switzerland, and colleagues randomly assigned 55 patients with uncomplicated, painful chronic pancreatitis and calcifications obstructing the main pancreatic duct to receive either extracorporeal shock wave lithotripsy alone or extracorporeal shock wave lithotripsy with endoscopy.

After two years, the researchers found that pain relapse rates were 38 percent in the extracorporeal shock wave lithotripsy alone group and 45 percent in the combined treatment group. However, the combined treatment was three times as expensive as lithotripsy alone. In both groups, they observed similar mean decreases in main pancreatic duct diameter (1.7 millimeter) and frequency of pain episodes per year (3.7).

"Treatment with extracorporeal shock wave lithotripsy alone as a first option does not impede further endoscopic or surgical treatment, and patients' selection for extracorporeal shock wave lithotripsy can be based on fully non-invasive tests, as shown in this study. Patients with calcifications confined to the head of the pancreas are the best candidates for benefiting from this treatment," the study concluded.

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