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Wang D. et al., 2022: Pancreatic extracorporeal shock wave lithotripsy for a patient concurrent with autosomal dominant polycystic kidney disease: a case report.

Wang D, Xu J, Bi YW, Mei CL, Li ZS, Hu LH.
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
Department of Nephrology, Kidney Institute of Chinese PLA, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China.

Abstract

Whether pancreatic extracorporeal shock wave lithotripsy (ESWL) is safe for patients with autosomal dominant polycystic kidney disease (ADPKD) is unclear. A woman in her early 30s was admitted to our hospital because of intermittent upper abdominal pain and recurrent pancreatitis. The imaging results confirmed the diagnosis of pancreatic stones and ADPKD. We performed pancreatic ESWL using a third-generation lithotripter to pulverize the pancreatic stones. A maximum of 5000 shock waves was delivered per therapeutic session. A second session of ESWL was performed the next day. The patient developed no adverse events or complications related to pancreatic ESWL. Three years after treatment, the patient had developed no relapse of pancreatitis or abdominal pain. Shock waves do not lead to complications such as hematuria, cyst rupture, or deterioration of the inner bleeding of renal cysts. Multiple kidney cysts are not a contraindication for pancreatic ESWL.
J Int Med Res. 2022 May;50(5):3000605221100748. doi: 10.1177/03000605221100748.PMID: 35634907. FREE ARTICLE

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Comments 1

Hans-Göran Tiselius on Monday, 10 October 2022 10:40

The authors have published this case report to show that when pancreatic stones were treated with SWL, there were no negative side effects on kidneys with polycystic disease.

It had been of value if an attempt had been made to visualize how and to which extent the shockwave path interfered with the renal tissue and cysts.
In view of the authors’ concern about the possibility of kidney damage during pancreatic SWL, it is surprising that that they decided to go on with a second SWL session already on the following day! Particularly when as many as 5000 shockwaves were administered during the first session. The procedure was uneventful and there were no kidney injuries, but that was unknown before the treatment.

Hans-Göran Tiselius

The authors have published this case report to show that when pancreatic stones were treated with SWL, there were no negative side effects on kidneys with polycystic disease. It had been of value if an attempt had been made to visualize how and to which extent the shockwave path interfered with the renal tissue and cysts. In view of the authors’ concern about the possibility of kidney damage during pancreatic SWL, it is surprising that that they decided to go on with a second SWL session already on the following day! Particularly when as many as 5000 shockwaves were administered during the first session. The procedure was uneventful and there were no kidney injuries, but that was unknown before the treatment. Hans-Göran Tiselius
Monday, 20 May 2024