The studies of extracorporeal shock wave lithotripsy (ESWL) for pancreatic ductal stones

Norihito Taki, Saburo Nakazawa, Kenji Yamao, Kazumu Okushima, Junji Yoshino, Kazuo Inui, Hitoshi Yamachika, Naoto Kanemaki, Takao Wakabayashi, Teruhiko Iwase, Hironao Miyoshi, Takashi Kobayashi, Kazuhisa Sugiyama, Hiroshi Nishio, Yuta Nakamura, Sayoko Mizutani, Ryuichi Kato, Toushin Takashima, Naomi Asai, Shinya Watanabe

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

30 patients with main pancreatic duct stones were treated by ESWL. In 18 of 22 patients who had not previously undergone endoscopic pancreatic sphincterotomy (EPST) or endoscopic sphincterotomy (EST), the stone fragments disappeared after ESWL. The fragments were removed endoscopically in the remaining 4 cases. Complete clearance was achieved in 8 cases with endoscopically unextractable stones by ESWL. After the ESWL procedure, absolute relief from pain was reported by in 19 of 22 patients with abdominal complaints. Serum amylase levels decreased significantly, and dilatation of the main pancreatic duct (MPD) was reduced. In the medium-term follow-up period, pancreatic exocrine function and endocrine function had a possibility to be preserved. One case of pancreatic cancer and one case of an intraductal papillary tumor of the pancreas were found, indicating that careful observation is necessary even after complete removal of pancreatic stones. In cases of Santorini duct dominant, multiple stones, or stricture of the MPD, ESWL should be combined with EPST and endoscopic stenting for preventing recurrence of acute pancreatitis and pancreatic stones. In conclusion, ESWL is the first choice of treatment for pancreatolithiasis and useful procedure and the limited complications.

Original languageEnglish
Pages (from-to)101-110
Number of pages10
JournalJapanese Journal of Gastroenterology
Volume94
Issue number2
Publication statusPublished - 01-02-1997

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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