EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY IS SAFE AND EFFECTIVE FOR GERIATRIC PATIENTS WITH CHRONIC PANCREATITIS

Aims:

Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is the first-line treatment for chronic pancreatitis (CP) patients with pancreatic stones. However, the performance of P-EWSL in geriatric patients remains unclear. We aimed to evaluate the safety and efficacy of P-ESWL for geriatric CP patients.

Methods:

This prospective study was conducted in painful CP patients who underwent P-ESWL. Patients aged over 65 years were included in the geriatric group; patients aged under 65 years were assigned to the control group. For the long-term follow-up investigation, geriatric patients were matched with patients from the control group in a 1:1 ratio. Primary outcomes were complications of P-ESWL and pain relief. Secondary outcomes included: stone clearance, physical and mental health, quality of life score, changes in exocrine and endocrine pancreatic function, and survival.

Results:

From March 2011 to March 2016, P-ESWL was performed in 1,404 patients (72 in the geriatric group, 1,332 in the control group). No significant differences were observed in the complications of P-ESWL between the two groups (P= 0.364). Among the 67 (67/72, 93.1%) geriatric patients who underwent follow-up for 4.02 years, complete pain relief was achieved in 53 patients, which was not significantly different from that of matched controls (54/70; P= 0.920). The death in the geriatrics was significantly higher (P= 0.007), but none of them were correlated with P-ESWL.

Conclusions:

P-ESWL is safe and effective for geriatric patients with CP. It can promote significant pain relief and stone clearance, and improve quality of life, mental and physical health.

Trial registration: ClinicalTrials.gov (NCT03373682)