Efficacy of Different Pancreatic Interventional Treatments for Chronic Calcific Pancreatitis: A Two-Year Multicenter Retrospective Study

Wen Bao; Deqing Wu; Wei Han; Rui Kong; Nan Wang; Jie Lu

doi:10.2147/IJGM.S383780

Efficacy of Different Pancreatic Interventional Treatments for Chronic Calcific Pancreatitis: A Two-Year Multicenter Retrospective Study

Int J Gen Med. 2022 Sep 25:15:7511-7521. doi: 10.2147/IJGM.S383780. eCollection 2022.

Authors

Wen Bao^#¹, Deqing Wu^#¹, Wei Han¹, Rui Kong¹, Nan Wang¹, Jie Lu²

Affiliations

¹ Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, People's Republic of China.
² Department of Gastroenterology, Gongli Hospital, School of Medicine, Shanghai University, Shanghai, 200135, People's Republic of China.

^# Contributed equally.

Abstract

Background: Extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde cholangiopancreatography (ERCP) are the main treatments for chronic calcific pancreatitis (CCP). However, clinical outcomes remain unclear for patients underwent different interventional therapies based on these two techniques.

Methods: A total of 125 patients with CCP who underwent ESWL, ERCP or a combined treatment at two medical centers from January 2019 to January 2020 were considered. Patients were divided into four groups according to intervention types (ESWL-alone, ERCP-alone, ESWL-ERCP and ERCP-ESWL). A retrospective survey with a follow-up for 2 years was conducted. The main outcome measures were postoperative complications, abdominal pain and re-intervention during the follow-up. Possible prognostic factors were evaluated by multivariate analysis.

Results: Patients in ESWL-ERCP group had the highest complete pain relief rate (49.28%), the lowest pain frequency (1 time/year) and intensity (VAS-score, 1.84±1.93) during the follow-up, which were statistically significant compared with the other three groups. ESWL-ERCP group also had the lowest postoperative complication rate (6%), while the highest complication rate (16%) was observed in ESWL-alone group. Both ESWL-alone and ESWL-ERCP group had significant lower frequencies of re-interventions (0.44 ± 0.73, 0.57±0.98, respectively) after the initial treatments. An analysis of treatment-based prognostic factors found significant interactions between age, course of CCP, max pancreatic duct stone diameter, calcium, glycosylated hemoglobin (HbA1c) and triglyceride.

Conclusion: ESWL-ERCP was considered as the most effective interventional therapy for CCP with a better safety in a two-year follow-up. Prognostic factors may help to determine the patients who benefit by this technique.

Keywords: ERCP; ESWL; chronic calcific pancreatitis; follow-up.

Grants and funding

This study was supported by the National Natural Science Foundation of China (NSFC) (No. 81770518), Shanghai “Rising Stars of Medical Talent” Youth Development Program-Outstanding Youth Medical Talents (No. SHWJRS2021-99), Shanghai Pudong New Area Science and Technology Commission (No. PKJ2021-Y10).