Evaluation of Pancreatic Damage After Extracorporeal Shock Wave Lithotripsy, Percutaneous Stone Surgery, and Ureteroscopy

• Published in: Urology (Ridgewood, N.J.) Vol. 77; no. 6; pp. 1288 - 1291
• Main Authors: Thiel, David D, Brisson, Theodore E, Heckman, Michael G, Arnold, Michelle, Haley, William, Khambhati, Jay, Wehle, Michael J, Igel, Todd C, Parker, Alexander S
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2011; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Amylases - blood; Biological and medical sciences; Female; Humans; Kidney Calculi - complications; Kidney Calculi - therapy; Lipase - blood; Lithotripsy - adverse effects; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephrostomy, Percutaneous - adverse effects; Pancreas - injuries; Pancreas - pathology; Prospective Studies; Time Factors; Treatment Outcome; Ureteroscopy - adverse effects; Urology; Evaluation; Nephrology; Surgery; Lithotripsy; Instrumentation therapy; Endoscopy; Lesion; Ureteroscopy; Pancreas; Shock wave; Urology; Percutaneous route
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2010.08.066

Objectives To complete a prospective evaluation of serum amylase and lipase levels before and after shock wave lithotripsy (SWL) for renal stones. We also compared these serum levels to those of patients undergoing percutaneous and ureteroscopic stone surgery. SWL injury to the pancreas should be noted by an increase in serum amylase and lipase. Methods A prospective evaluation of 38 patients (16 who underwent SWL, 15 who underwent percutaneous nephrostolithotomy, and 7 who underwent ureteroscopic stone manipulation) who underwent treatment of renal calculi at our institution was completed. The control group was the combined group of patients who had undergone percutaneous nephrostolithotomy or ureteroscopic stone manipulation. The serum amylase and lipase levels were measured before the procedure, immediately after the procedure (2 hours), and ≥30 days after the procedure. Results No statistically significant difference was found in the change from before to immediately after the procedure between the SWL group and the controls in amylase (median decrease 6 U/L vs 11 U/L, P = .45) or lipase (median decrease 4 U/L vs 9 U/L, P = .31). Also, no statistically significant evidence was seen in the change from before to >30 days after the procedure between the SWL group and controls in the amylase level (median increase 0 U/L vs 2 U/L, P = 1.00) or lipase (median change 2 U/L increase vs 1 U/L decrease, P = .96). Conclusions SWL does not appear to noticeably increase the serum amylase and lipase level directly postoperatively or >30 days after the procedure compared with baseline or compared with the controls.