Efficiency of extracorporeal shock wave lithotripsy in treating children with chronic pancreatitis

Introduction: Extracorporeal shock wave lithotripsy (ESWL) of pancreatic stones is a treatment option for patients with chronic pancreatitis (CP), when pancreatic stones cannot be removed by endoscopic procedures during retrograde cholangiopancreatography (ERCP).
Aim: The aim of the study was to evaluate whether ESWL of pancreatic stones is effective in treating children with chronic pancreatitis.
Material and methods: 9 children (6 girls and 3 boys, mean age 10.8 years, range 5.5 to 17 years) with chronic pancreatitis, hospitalized at the Department Of Gastroenterology, Hepatology and Immunology, The Children’s Memorial Health Institute in the period 1998-2005 were treated by extracorporeal shock wave lithotripsy for endoscopically irretrievable obstructive stones. ESWL was performed with an electromagnetic lithotriptor. The aetiologies of chronic pancreatitis were gene mutations (PRSS1, CFTR) in all but one patient.
Results: Nine patients had 11 ESWL sessions. ESWL was administered twice in two children. Pancreatic stone fragmentation was achieved in all patients. The procedures were well tolerated by all children. There were no complications related to ESWL. Early pain relief occurred in all cases. At a mean follow-up of 49 months (range: 26-78 months) pain improved in 5 (62.5%) children. Acute episodes of CP were observed in 3 (37.5%) patients. Recurrence of pancreatic stones was revealed in two cases.
Conclusion: Extracorporeal shock wave lithotripsy is a safe and effective therapy in treating children with chronic pancreatitis and irreversible pancreatic stones.