Non-surgical treatment for pancreatic stone - With reference to extracorporeal shock wave lithotripsy (ESWL) and endoscopic treatment

Indication for the treatment of pancreatic stone consists of symptomatic state (pain), presence of pancreatic stone within the main or accessory pancreatic duct and relatively well preserved pencreatic function. Furthermore, when the therapeutic effect and risk of recurrence are taken in account, the stone (s) should be single or small in number, stone size should be small, there should be no multiple stenoses of the main pancreatic duct and, if there are multiple stenoses, they should be localized within the head of the pencreas. If the cases are carefully chosen as above, removal of pancreatic stone can be securely performed endoscopically or by ESWL, or by their combination. Long-term outcome and effect of combination with stenting in the cases with main pancreatic duct stenosis are to be further studied.