title: [The studies of extracorporeal shock wave lithotripsy (ESWL) for pancreatic ductal stones].
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.
authors.affiliation: Department of Internal Medicine, Second Teaching Hospital, Fujita Health University, School of Medicine.
authors.forename: N
authors.initials: N
authors.lastname: Taki
authors.forename: S
authors.initials: S
authors.lastname: Nakazawa
authors.forename: K
authors.initials: K
authors.lastname: Yamao
authors.forename: K
authors.initials: K
authors.lastname: Okushima
authors.forename: J
authors.initials: J
authors.lastname: Yoshino
authors.forename: K
authors.initials: K
authors.lastname: Inui
authors.forename: H
authors.initials: H
authors.lastname: Yamachika
authors.forename: N
authors.initials: N
authors.lastname: Kanemaki
authors.forename: T
authors.initials: T
authors.lastname: Wakabayashi
authors.forename: T
authors.initials: T
authors.lastname: Iwase
authors.forename: H
authors.initials: H
authors.lastname: Miyoshi
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: K
authors.initials: K
authors.lastname: Sugiyama
authors.forename: H
authors.initials: H
authors.lastname: Nishio
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: S
authors.initials: S
authors.lastname: Mizutani
authors.forename: R
authors.initials: R
authors.lastname: Kato
authors.forename: T
authors.initials: T
authors.lastname: Takashima
authors.forename: N
authors.initials: N
authors.lastname: Asai
authors.forename: S
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D002137:Calculi / Q000628:therapy*; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts