AI Article Synopsis

  • Extracorporeal shock wave lithotripsy (ESWL) is used to treat pancreatic duct stones (PDS) in patients with chronic pancreatitis (CP), and the study aimed to create a CT-based index to predict how many ESWL sessions are needed for success.
  • Researchers evaluated 206 patients and found that larger PDS and higher density were significantly correlated with the number of sessions required, with stones in the head of the pancreas needing fewer sessions than those in the body.
  • The resulting PDS index can help predict the number of ESWL sessions required for successful stone fragmentation, which improves patient management and counseling with a high accuracy rate.

Article Abstract

Background & Aim: Extracorporeal shock wave lithotripsy (ESWL) is used for the treatment of pancreatic duct stones (PDS) in patients with chronic pancreatitis (CP). We aimed to develop a CT based index to predict the required number of ESWL sessions for technical success.

Methods: We retrospectively evaluated patients with PDS secondary to CP who underwent ESWL. Technical success was defined as the complete fragmentation of stones to <3 mm. CT features including PDS size, number, location, and density in Hounsfield units (HU) were noted. We analyzed the relationship between PDS characteristics and the number of ESWL sessions required for technical success. A multiple linear regression model was used to combine size and density into the pancreatic duct stone (PDS) index that was translated into a web-based calculator.

Results: There were 206 subjects (mean age 38.6 ± 13.7 years, 59.2% male) who underwent ESWL. PDS size showed a moderate correlation with the number of ESWL sessions (r = 0.42, p < 0.01). PDS in the head required a fewer number of sessions in comparison to those in the body (1.4 ± 0.6 vs. 1.6 ± 0.7, p = 0.01). There was a strong correlation between PDS density and the number of ESWL sessions (r = 0.617, p-value <0.01). The PDS index {0.3793 + [0.0009755 x PDS density (HU)] + [0.02549 x PDS size (mm)]} could accurately predict the required number of ESWL sessions with an AUC of 0.872 (p < 0.01).

Conclusion: The PDS index is a useful predictor of the number of ESWL sessions needed for technical success that can help in planning and patient counseling.

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Source
http://dx.doi.org/10.1016/j.pan.2024.03.018DOI Listing

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