[Disintegration of pancreatic duct stones with extracorporeal shockwave lithotripsy].
OBJECTIVE
Treatment of pancreatic duct stones by extracorporeal shockwave lithotripsy (ESWL) serves as a nonsurgical treatment modality in patients with stones that are located in upstream of the strictures or in patients with impacted stones. We present the results of ESWL in endoscopically unretrievable pancreatic duct stones in the past 2 years.


METHODS
Between January 2002 and December 2003, 58 patients with chronic pancreatitis were treated by ESWL for pancreatic duct stones. ESWL was performed with an electrohydraulic lithotripter ultrasound focusing system.


RESULTS
The mean number of shockwave treatments was 2.5, and the patients received 4,578 (1,527-10,155) shockwave discharges with a mean energy of 15.8 kV. Fragmentations of the stones were achieved in 54 patients (93.2%), and complete clearance of the stones were noticed in 27 patients (46.6%). Fragmentation of stones equal or less than 3 mm in diameter was associated with successful removal of stones (p<0.05). Complete relief of pain occurred in 32 patients (55.2%). The procedures were well tolerated and no patient had significant complications such as acute pancreatitis.


CONCLUSIONS
ESWL is an effective and a safe procedure for endoscopically unretrievable main pancreatic duct stones. ESWL combined with endoscopic therapy can increase the success rate of nonsurgical removal of pancreatic duct stones in patients with chronic pancreatitis.
Choi
Kwi-Sook
KS
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim
Myung-Hwan
MH
Lee
Yoon-Seon
YS
Kim
Jong Cheol
JC
Choi
Eun Kwang
EK
Han
Jimin
J
Kim
Min Kyung
MK
Yoon
Soon Man
SM
Seo
Dong Wan
DW
Lee
Sang Soo
SS
Lee
Sung Koo
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D002137:Calculi / Q000628:therapy*; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000628:therapy*; D010183:Pancreatic Ducts; D050500:Pancreatitis, Chronic / Q000150:complications