Zhao-Shen Li

Second Military Medical University, Shanghai, Shanghai, Shanghai Shi, China

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Publications (195)645.3 Total impact

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    ABSTRACT: Introduction: High-dose intravenous esomeprazole is the only approved pharmacological treatment for the prevention of peptic ulcer rebleeding (currently approved in over 100 countries worldwide), but has not yet been approved in China. This study aimed to evaluate a high-dose esomeprazole intravenous regimen vs. an active control (cimetidine) for the prevention of rebleeding in Chinese patients with a high risk of peptic ulcer rebleeding who had undergone primary endoscopic hemostatic treatment. Methods: This was a parallel-group study conducted at 20 centers in China. The study comprised a randomized, double-blind, intravenous treatment phase of 72 h in which 215 patients received either high-dose esomeprazole (80 mg + 8 mg/h) or cimetidine (200 mg + 60 mg/h), followed by an open-label oral treatment phase in which all patients received esomeprazole 40 mg tablets once daily for 27 days. The primary outcome was the rate of clinically significant rebleeding within the first 72 h after initial endoscopic hemostatic therapy. Secondary outcomes included the rates of clinically significant rebleeding within 7 and 30 days; proportions of patients who had endoscopic retreatment and other surgery due to rebleeding; and number of blood units transfused. Results: The rate of clinically significant rebleeding within 72 h was low overall (3.3%) and numerically lower in patients treated with esomeprazole compared with cimetidine (0.9% vs. 5.6%). Overall, the results of the secondary outcomes also showed a numerical trend towards superiority of esomeprazole over cimetidine. All treatments were well tolerated. Conclusion: In this phase 3, multicenter, randomized trial conducted in China, esomeprazole showed a numerical trend towards superior clinical benefit over cimetidine in the prevention of rebleeding in patients who had successfully undergone initial hemostatic therapy of a bleeding peptic ulcer, with a similar safety and tolerability profile. These findings suggest that esomeprazole may be an alternative treatment option to cimetidine for this indication in China. Funding: AstraZeneca. Trial registration: ClinicalTrials.gov identifier, NCT01757275.
    Advances in Therapy 11/2015; DOI:10.1007/s12325-015-0265-6 · 2.27 Impact Factor
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    ABSTRACT: Background and aims: To investigate outcomes of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) for the removal of large pancreatic stones coexisting with pancreatic pseudocysts (PPCs) in chronic pancreatitis (CP). Methods: This is a prospective study performed in CP patients with at least one stone (≥5 mm). They were divided into the PPC group (stones coexisting with PPCs) and the control group (stones alone). The patients were initially subjected to successive P-ESWL treatments, followed by endoscopic retrograde cholangiopancreatography (ERCP). The primary outcomes were P-ESWL adverse events, and the secondary outcomes were stone clearance, and long-term pain relief, improved quality-of-life scores, and PPC regression. Results: A total of 849 patients (59 in the PPC group and 790 in the control group) were subjected to P-ESWL between March 2011 and October 2013. Occurrences of P-ESWL adverse events were similar between the PPC group and the control group (11.86% vs 12.41%, p = 0.940). After the treatment of initial P-ESWL combing with ERCP, the complete, partial, and nonclearance of stones occurred in 67.24%, 20.69%, and 12.07% of the patients in PPC group, with no significant difference from the control group (complete, partial, and nonclearance: 83.17%, 10.40%, and 11.39%, respectively; p = 0.106). Fifty-five (55/59, 93.22%) patients with PPCs were followed up for a median period of 21.9 months (range: 12.0-45.1 months). PPCs disappeared in 56.36% (31/55) and 76.36% (42/55) of the patients after 3 months and 1 year of follow-up visits, respectively. Moreover, complete and partial pain relief were achieved in 63.64% (35/55) and 25.45% (14/55) of the patients, respectively. The scores for the quality of life (p < 0.001), physical health (p < 0.001), and weight loss (p < 0.001) improved. Conclusions: In multispecialty tertiary center, initial P-ESWL followed by ERCP is safe in patients with coexisting pancreatic stones and PPCs and effective for stone clearance, main pancreatic duct drainage, and pain relief.
    Gastrointestinal endoscopy 11/2015; DOI:10.1016/j.gie.2015.10.026 · 5.37 Impact Factor
  • Wen-Bin Zou · Liang-Hao Hu · Jia-Yun Chen · Ping Ye · Zhuan Liao · Zhao-Shen Li ·
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    ABSTRACT: This study examined a 60-year-old female patient with chronic pancreatitis and hemosuccus pancreaticus (HP), who was once misdiagnosed with biliary bleeding because of choledocholithiasis and T-tube drainage. Bleeding from the T-tube was demonstrated as a side effect of HP. The difficulty in diagnosing this case was attributed to the absence of pseudocysts or obvious aneurysms on CT images. Conclusively, for patients with indirect signs of biliary bleeding, such as bleeding from a T-tube, the possibility of the symptoms being side effects of pancreatic bleeding should be considered.
    Pancreatology 10/2015; DOI:10.1016/j.pan.2015.09.011 · 2.84 Impact Factor
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    ABSTRACT: Objectives: This study aims to evaluate prospectively the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) in Chinese patients. Methods: A total of 214 patients with painful chronic pancreatitis and pancreatic stones who underwent ESWL followed by endoscopic retrograde cholangiopancreatography from March 2011 to February 2012 in Changhai Hospital were enrolled. The main pancreatic duct clearance rate and complications were recorded prospectively. Symptoms, weight, quality of life, and pancreatic function were assessed before and after ESWL and endotherapy. Results: A total of 473 ESWL procedures were performed in 214 patients. Stones were fragmented in all cases. Complete clearance of main pancreatic duct stones and successful endoscopic decompression were achieved in 155 (72.4%) and 188 (90.8%) of 214 patients, respectively. Complications were observed after 20 sessions (20 of 473, 4.23%). Follow-up (n = 195) after 18.5 ± 3.3 months showed that complete and partial pain relief were achieved in 71.3% and 24.0% of the patients, respectively. The scores for the quality of life (5.8 ± 1.7 vs 8.1 ± 1.2, P < 0.05) and mental health from the Medical Outcomes Study 36-Item Short-Form General Health Survey questionnaire (62.2 ± 21.5 vs 68.5 ± 16.4, P < 0.05) improved after ESWL. Conclusions: Thus, ESWL is a safe and effective method to treat Chinese patients with pancreatic stones. This procedure can significantly improve the success rate of endotherapy.
    Pancreas 09/2015; DOI:10.1097/MPA.0000000000000464 · 2.96 Impact Factor
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    ABSTRACT: Colorectal laterally spreading tumors (LSTs) are divided into homogenous (LST-G-H), nodular mixed (LST-G-M), flat elevated (LST-NG-F), and pseudodepressed (LST-NG-PD) subtypes. We hypothesized that based on rates of advanced histology, the recurrence rates of the LST-NG-PD and LST-G-M group may be higher than those of the other subgroups. Endoscopic submucosal dissection (ESD) was performed in 156 patients with 177 LSTs. The clinicopathological features and long-term prognosis of ESD according to specific subtype were investigated. LSTs were most commonly found in the rectum, and the highest percentage of rectal lesions was observed in the LST-G-M group (71.1% vs. overall 55.4%, P = 0.032). The LST-G-M lesions were larger (60 ± 22 mm vs. 40 ± 33 mm, P = 0.034) than the LST-G-H lesions. The LST-G-M group also demonstrated more high-grade intraepithelial neoplasias (32.2% vs. 10.8%, P = 0.003) and submucosal carcinomas (13.6% vs. 1.5%, P = 0.010) compared with the LST-G-H group. The LST-NG-PD group exhibited the highest incidence of submucosally invasive cancer (16.7%). The overall perforation rate was 2.3%. The perforation in the LST-NG group was higher than that in the LST-G group (5.7% vs. 0.8%, P = 0.047). All recurrences (7.7%) were found by colonoscopy without any detection of cancers and no difference was found among the subtypes. No significant differences were observed among subgroups with a 44.4 ± 16.3 months follow-up. Considering that all recurrences were discovered through colonoscopy, and most can be cured by repeated ESD, the LSTs of all subgroups require more intensive follow-up compared with smaller adenomatous lesions. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
    Gastrointestinal endoscopy 09/2015; DOI:10.1016/j.gie.2015.08.043 · 5.37 Impact Factor
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    Liang-Hao Hu · Jun-Tao Ji · Zhao-Shen Li ·
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    ABSTRACT: Chronic pancreatitis (CP) is a progressive inflammatory disease typified by end-stage fibrosis. This disease can also increase the risk of pancreatic cancer. The associated diagnosis, pain and other complications further add to the burden of disease management. In recent years, significant progress has been achieved in identifying miRNAs and their physiological functions, including mRNA repression and protein expression control. Given the extensive effort made on miRNA research, a close correlation has been discovered between certain types of miRNAs and disease progression, particularly for tissue fibrosis. Designing miRNA-related tools for disease diagnosis and therapeutic treatments presents a novel and potential research frontier. In the current review, we discuss various miRNAs closely interacting with CP, as well as the possible development of targeted miRNA therapies in managing this disease. © 2015 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.
    Journal of Cellular and Molecular Medicine 07/2015; 19(9). DOI:10.1111/jcmm.12603 · 4.01 Impact Factor
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    Fei Gao · Hao-Jie Huang · Jun Gao · Zhao-Shen Li · Shu-Ren Ma ·
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    ABSTRACT: Tumor suppressor gene silencing via promoter hypermethylation is an important event in pancreatic cancer pathogenesis. Aberrant DNA hypermethylation events are highly tumor specific, and may provide a diagnostic tool for pancreatic cancer patients. The objective of the current study was to identify novel methylation-related genes that may potentially be used to establish novel therapeutic and diagnostic strategies against pancreatic cancer. The methylation status of the GS homeobox 2 (GSH2) gene was analyzed using the sodium bisulfite sequencing method. The GSH2 methylation ratio was examined in primary carcinomas and corresponding normal tissues derived from 47 patients with pancreatic cancer, using quantitative methylation-specific polymerase chain reaction. Methylation ratios were found to be associated with the patient's clinicopathological features. GSH2 gene methylation was detected in 26 (55.3%) of the 47 pancreatic cancer patients, indicating that it occurs frequently in pancreatic cancer. A significant association with methylation was observed for tumor-node-metastasis stage (P=0.031). GSH2 may be a novel methylation-sensitive tumor suppressor gene in pancreatic cancer and may be a tumor-specific biomarker of the disease.
    Oncology letters 07/2015; 10(1):387-391. DOI:10.3892/ol.2015.3241 · 1.55 Impact Factor
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    ABSTRACT: Pancreas is a retroperitoneally located organ, and thus general CT and MRI have a very limited specificity and sensitivity in diagnosing pancreatic diseases. However, endoscopic ultrasonography (EUS) with a better differential diagnostic capability of detecting pancreatic morphology and properties through gastric wall has been widely accepted by physicians and become one of the first-line methods compared with other techniques. Currently, common technologies used in the diagnosis and treatment of pancreatic diseases include EUS-guided fine needle aspiration (EUS-FNA), EUS-guided drainage, EUS-guided pancreatic cysts ablation, EUS-assisted radiotherapy, and EUS-guided celiac plexus neurolysis (EUS-CPN), etc. Recent innovative applications include contrast-enhanced EUS with Doppler mode, contrast-enhanced harmonic EUS, and EUS elastography. The clinical application of EUS in pancreatic diseases has been overviewed.
    Current Signal Transduction Therapy 06/2015; 10(999):1-1. DOI:10.2174/1574362410666150615222344 · 0.45 Impact Factor
  • Wen-Bin Zou · Xiao-Hua Hou · Lei Xin · Jun Liu · Lu-Min Bo · Guan-Yu Yu · Zhuan Liao · Zhao-Shen Li ·
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    ABSTRACT: Background and study aims: We developed a novel magnetic-controlled capsule endoscopy (MCE) system for use in the human stomach. The aim of the current study was to compare the diagnostic accuracy of MCE with that of standard gastroscopy for gastric diseases. Patients and methods: A total of 68 patients were enrolled in this self-controlled trial. Patients were evaluated by both MCE and gastroscopy. Gastroscopy was performed 4 – 24 hours after completion of the MCE examination. Results: The positive percent agreement between MCE and gastroscopy was 96.0 %, and the negative percent agreement was 77.8 %. The overall agreement was 91.2 % with a kappa value of 0.765 (P < 0.001). A total of 68 pathological findings were detected, of which 53 were identified by both methods. The MCE and standard gastroscopy missed seven and eight findings, respectively. Conclusions: MCE showed a diagnostic accuracy similar to that of standard gastroscopy. These results suggest that MCE is a promising alternative to gastroscopy for noninvasive screening of gastric diseases.Clinical trial registration number: NCT01903629.
    Endoscopy 06/2015; 47(06). DOI:10.1055/s-0034-1391123 · 5.05 Impact Factor
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    ABSTRACT: The mechanisms associated with diabetes‑induced neuropathic pain are complex and poorly understood. In order to understand the involvement of spinal microglia activity in diabetic pain, the present study investigated whether minocycline treatment is able to attenuate diabetic pain using a rat model. Diabetes was induced using a single intraperitoneal injection of streptozotocin (STZ). Minocycline was then intrathecally administered to the rats. Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were tested weekly. The expression of OX‑42, Iba‑1, phospho‑p38 mitogen‑activated protein kinase (MAPK), tumor necrosis factor‑α (TNF‑α), interleukin‑1β (IL‑1β) and inducible nitric oxide synthase (iNOS), were examined in the spinal cord in order to evaluate the activation of microglia. The present study demonstrated that rats with STZ‑induced diabetes exhibited increased mean plasma glucose concentration, decreased mean body weight and significant pain hypersensitivity compared with control rats. PWT and PWL values of rats with STZ‑induced diabetes increased following treatment with minocycline. No differences were observed in expression levels of the microglial activity markers (OX‑42, Iba‑1 and phospho‑p38 MAPK) between rats with STZ‑induced diabetes and control rats. However, TNF‑α, IL‑1β and iNOS expression levels were higher in rats with STZ‑induced diabetes compared with control rats. Following treatment with minocycline markers of microglial activation, including cytokines and iNOS, were downregulated in rats with STZ‑induced diabetes. The results of the present study indicated that minocycline treatment may inhibit spinal microglial activation and attenuate diabetic pain in rats with STZ‑induced diabetes.
    Molecular Medicine Reports 05/2015; 12(2). DOI:10.3892/mmr.2015.3735 · 1.55 Impact Factor
  • Bai-Rong Li · Gao-Ping Mao · Liang-Hao Hu · Zhao-Shen Li ·
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    ABSTRACT: The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf of the American College of Gastroenterology (ACG). Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) provides practical and professional support for clinicians dealing with the gastroenterological disorders seen most often in patients. Published with practicing clinicians in mind, the journal aims to be easily accessible, organizing its content by topic, both online and in print. www.amjgastro.com, *2007 Journal Citation Report (Thomson Reuters, 2008)
    The American Journal of Gastroenterology 05/2015; 110(5):773-774. DOI:10.1038/ajg.2015.107 · 10.76 Impact Factor
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    ABSTRACT: Background: Helicobacter pylori (H. pylori) frequently colonizes the stomach. Gastroesophageal reflux disease (GERD) is a common and costly disease. But the relationship of H. pylori and GERD is still unclear. This study aimed to explore the effect of H. pylori and its eradication on reflux esophagitis therapy. Methods: Patients diagnosed with reflux esophagitis by endoscopy were enrolled; based on rapid urease test and Warth-Starry stain, they were divided into H. pylori positive and negative groups. H. pylori positive patients were randomly given H. pylori eradication treatment for 10 days, then esomeprazole 20 mg bid for 46 days. The other patients received esomeprazole 20 mg bid therapy for 8 weeks. After treatment, three patient groups were obtained: H. pylori positive eradicated, H. pylori positive uneradicated, and H. pylori negative. Before and after therapy, reflux symptoms were scored and compared. Healing rates were compared among groups. The χ2 test and t-test were used, respectively, for enumeration and measurement data. Results: There were 176 H. pylori positive (with 92 eradication cases) and 180 negative cases. Healing rates in the H. pylori positive eradicated and H. pylori positive uneradicated groups reached 80.4% and 79.8% (P = 0.911), with reflux symptom scores of 0.22 and 0.14 (P = 0.588). Healing rates of esophagitis in the H. pylori positive uneradicated and H. pylori negative groups were, respectively, 79.8% and 82.2% (P = 0.848); reflux symptom scores were 0.14 and 0.21 (P = 0.546). Conclusions: Based on esomeprazole therapy, H. pylori infection and eradication have no significant effect on reflux esophagitis therapy.
    Chinese medical journal 04/2015; 128(8):995. DOI:10.4103/0366-6999.155049 · 1.05 Impact Factor
  • Wen-Bin Zou · Fan Yang · Zhao-Shen Li ·
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    ABSTRACT: China has great burden of gastric cancer, and the diagnosis rate of early gastric cancer is relatively low (<10%). To perform screening, early endoscopic diagnosis and treatment of gastric cancer in high-risk population is a feasible and efficient way to change the current status. Therefore, the Chinese Society of Digestive Endoscopy recently issued Consensus on screening, ″Endoscopic diagnosis and treatment of early gastric cancer screening in China″. The consensus suggests a feasible and efficient strategy for early detection of gastric cancer: screening with non-invasive procedures, followed by intensive endoscopic examination for screened high-risk population. In this article, we also describe the current status, the causes, high-risk population and early diagnosis of gastric cancer in China; and review the new development of serology and endoscopic techniques for early diagnosis.
    Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences 04/2015; 44(1):9-14.
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    ABSTRACT: Vascular invasion is one of the most important prognostic factors for patients with hepatocellular carcinoma (HCC). The objective of the current, retrospective study was to determine the associations of ascites and hepatitis B viral factors (HBeAg and anti-HBe status and HBV DNA levels), as well as tumor-related factors (size, tumor number, grade, and location) with micro- or macroscopic vascular invasion in patients with HCC that developed as a result of hepatitis B virus (HBV)-related cirrhosis. A total of 336 consecutive patients were included. Potential factors associated with micro- or macroscopic vascular invasion were analyzed by logistic regression. Ascites were more commonly detected in patients with micro- or macroscopic vascular invasion, and the presence of ascites was independently associated with vascular invasion. Among patients with mild-to-moderate or severe ascites, the odds ratio for macroscopic vascular invasion was 4.83 (95 % confidence interval [CI] 2.29-10.16) and 11.87 (95 % CI 4.53-31.07), respectively. Similarly, the presence of ascites was associated with microscopic vascular invasion (OR 5.00; 95 % CI 1.23-20.31). In contrast, hepatitis B viral factors were not significantly associated with vascular invasion. The presence of ascites was associated with vascular invasion in patients with HBV-related cirrhotic HCC. Thus, patients with ascites, vascular invasion should be considered and more frequent surveillance should be performed after curative treatment.
    Tumor Biology 04/2015; 36(8). DOI:10.1007/s13277-015-3311-8 · 3.61 Impact Factor
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    ABSTRACT: Background and study aim: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains the most common complication of ERCP. Somatostatin may inhibit pancreatic secretion and has been tested for PEP prophylaxis. However, the results of previous studies are inconsistent. The aim of the current study was to investigate whether somatostatin can reduce the incidence of PEP. Patients and methods: The study was a multicenter, open-label, randomized controlled trial. A total of 908 patients with normal amylase levels who were undergoing ERCP were randomized to receive somatostatin 250 μg bolus injection before ERCP and 250 μg/hour intravenous infusion for 11 hours after ERCP (somatostatin group) or no somatostatin treatments (control group). The incidences of PEP and hyperamylasemia were compared in the two groups. Results: The full analysis set included 900 patients (445 in the somatostatin group, 455 in the control group). PEP developed in 34 patients (7.5 %) in the control group (95 % confidence interval [CI] 5.4 % - 10.3 %) and in 18 patients (4.0 %) in the somatostatin group (95 %CI 2.6 % - 6.3 %; P = 0.03). Hyperamylasemia occurred in 46 patients (10.1 %) in the control group (95 %CI 7.7 % - 13.2 %) and in 27 patients (6.1 %) in the somatostatin group (95 %CI 4.2 % - 8.7 %; P = 0.03). No perforation or death occurred during the study. Conclusions: This study showed that somatostatin was effective and safe for the prevention of PEP and hyperamylasemia in ERCP patients.(ClinicalTrials.gov number, NCT01431781). © Georg Thieme Verlag KG Stuttgart · New York.
    Endoscopy 01/2015; 47(05). DOI:10.1055/s-0034-1391227 · 5.05 Impact Factor

  • Endoscopy 12/2014; 46(12). DOI:10.1055/s-0034-1391146 · 5.05 Impact Factor
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    ABSTRACT: Autoimmune pancreatitis (AIP) is increasingly recognized as a unique subtype of pancreatitis. This study aimed to analyze the diagnosis and treatment of AIP patients from a tertiary care center in China. One hundred patients with AIP who had been treated from January 2005 to December 2012 in our hospital were enrolled in this study. We retrospectively reviewed the data of clinical manifestations, laboratory tests, imaging examinations, pathological examinations, treatment and outcomes of the patients. The median age of the patients at onset was 57 years (range 23-82) with a male to female ratio of 8.1:1. The common manifestations of the patients included obstructive jaundice (49 patients, 49.0%), abdominal pain (30, 30.0%), and acute pancreatitis (11, 11.0%). Biliary involvement was one of the most extrapancreatic manifestations (64, 64.0%). Fifty-six (56.0%) and 43 (43.0%) patients were classified into focal-type and diffuse-type respectively according to the imaging examinations. The levels of serum IgG and IgG4 were elevated in 69.4% (43/62) and 92.0% (69/75) patients. Pathological analysis of specimens from 27 patients supported the diagnosis of lymphoplasmacytic sclerosing pancreatitis, and marked (>10 cells/HPF) IgG4 positive cells were found in 20 (74.1%) patients. Steroid treatment and surgery as the main initial treatments were given to 41 (41.0%) and 28 (28.0%) patients, respectively. The remission rate after the initial treatment was 85.0%. Steroid was given as the treatment after relapse in most of the patients and the total remission rate at the end of follow-up was 96.0%. Clinical manifestations, laboratory tests, imaging and pathology examinations in combination could increase the diagnostic accuracy of AIP. Steroid treatment with an initial dose of 30 or 40 mg prednisone is effective and safe in most patients with AIP.
    Hepatobiliary & pancreatic diseases international: HBPD INT 12/2014; 13(6):642-8. DOI:10.1016/S1499-3872(14)60263-0 · 1.17 Impact Factor
  • Dan Wang · Jin-Huan Lin · Liang-Hao Hu · Zhao-Shen Li ·

    Digestive and Liver Disease 11/2014; 47(2). DOI:10.1016/j.dld.2014.10.012 · 2.96 Impact Factor
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    ABSTRACT: Aim: To determine the existence of a potential relationship between the methylation state of the Vimentin gene and its prognostic value in pancreatic cancer. Methods: Sixty-four primary tumor specimens and normal tissues were collected consecutively from pancreatic cancer patients during surgery at Hangzhou First People's Hospital and Affiliated Hospital of the Logistics University of the Chinese People's Armed Police Force. DNA was extracted from the samples and subsequently quantitative methylation-specific polymerase chain reaction was used to detect the Vimentin methylation status of the samples. All of the patients were followed up to December 2012. χ(2) test, Kaplan-Meier survival and Cox regression statistical models were used. Results: Out of 64 pancreatic cancer tissues, 21 were marked as Vimentin methylation-positive, and 43 were marked as Vimentin methylation-negative. The location of pancreatic carcinoma was related to the Vimentin methylation state. The pathological T staging (P < 0.001), adjuvant chemotherapy (P = 0.003) and the Vimentin methylation state (P = 0.037) were independent prognostic factors. Conclusion: In our study, Vimentin methylation status can predict the prognosis of pancreatic cancer patients. However, additional experiments and clinical trials are needed to accurately validate this observation.
    09/2014; 20(36):13172-7. DOI:10.3748/wjg.v20.i36.13172
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    ABSTRACT: Background and study aims: Extracorporeal shock wave lithotripsy is recommended as treatment for stones in chronic pancreatitis. The aim of this study was to investigate the risk factors for complications of pancreatic extracorporeal shock wave lithotripsy (P-ESWL). Patients and methods: Patients with painful chronic pancreatitis and pancreatic stones (> 5 mm diameter) who were treated with P-ESWL between March 2011 and June 2013 were prospectively included. Adverse events after P-ESWL were classified as complications and transient adverse events, depending on severity. The major complications of P-ESWL included post-ESWL pancreatitis, bleeding, infection, steinstrasse, and perforation. Multivariate analyses based on univariate analysis were performed to detect risk factors of overall and moderate-to-severe complications. Results: A total of 634 patients underwent 1470 P-ESWL procedures. The overall complication rate was 6.7 % of all procedures. Complications occurred in 62 patients (9.8 %) after the first ESWL procedure. The risk factors for complications were pancreas divisum (odds ratio [OR] 1.28) and the interval between diagnosis of chronic pancreatitis and P-ESWL (OR 1.28). Protective factors were male sex (OR 0.50), diabetes (OR 0.45), and steatorrhea (OR 0.43). Male sex, the only identified predictor for moderate-to-severe complications, was a protective factor (OR 0.19). For the second P-ESWL procedure, complications occurred in 22/409 patients (5.4 %). Complication and asymptomatic hyperamylasemia after the first ESWL session were significantly associated with higher risk for complications after the second ESWL session (P < 0.05). Conclusions: Patient-related factors were important in determining a high risk of P-ESWL complications when no procedure-related factors were identified. Patients suffering from complications after the first ESWL session were also likely to experience complications in subsequent P-ESWL sessions.
    Endoscopy 09/2014; 46(12). DOI:10.1055/s-0034-1377753 · 5.05 Impact Factor

Publication Stats

2k Citations
645.30 Total Impact Points


  • 2007-2015
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China
  • 2000-2015
    • Changhai Hospital, Shanghai
      Shanghai, Shanghai Shi, China
  • 2014
    • Hangzhou First People's Hospital
      Hang-hsien, Zhejiang Sheng, China
  • 2012
    • Peking Union Medical College Hospital
      Peping, Beijing, China
  • 2010
    • Peking University
      Peping, Beijing, China