SONOGRAPHICALLY-GUIDED EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR PANCREATIC STONES IN PATIENTS WITH CHRONIC-PANCREATITIS

Over a 2 year period, 10 patients with pancreatic stones due to alcoho l induced chronic pancreatitis (proven by endoscopic retrograde pancre atography) underwent extracorporeal shockwave lithotripsy. Prior to sh ockwave therapy, all patients underwent endoscopic sphincterotomy. Tar geting of shockwave lithotripsy was exclusively performed under sonogr aphic control. All patients were treated with a second generation elec trohydraulic spark gap lithotriptor and fragmentation of concrements c ould be achieved in all cases. Complete duct clearance was confirmed i n seven patients by endoscopic retrograde pancreatography in one sessi on, with endoscopic fragment extraction by basket and/or balloon cathe ter. In three patients, balloon dilation of concomitant strictures loc ated in the head of the pancreas was performed prior to fragment extra ction. All stone-free patients showed no further symptoms over the fol low-up period of 12 months. Three patients in whom complete extraction of fragments was not successful experienced minor symptoms over the 1 2 month follow-up period.