EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY FOR OBSTRUCTING PANCREATIC DUCTCALCULI

Purpose: A review was done to determine the effectiveness of extracorp oreal shock wave lithotripsy (ESWL dagger) in the treatment of impacte d pancreatic duct calculi. Materials and Methods: A total of 19 patien ts, who were potential candidates for radical pancreatic surgery after unsuccessful endoscopic retrograde cholangiopancreatography, sphincte rotomy and attempted stone extraction from the pancreatic ducts, under went ESWL of the calculi. Followup ranged from 6 months to 6 years. Re sults: Of the 19 patients 14 avoided a major operation and 6 have rema ined pain-free for the long term. Two patients died of causes not rela ted to ESWL or endoscopic retrograde cholangiopancreatography. Five pa tients eventually underwent a Whipple or Puestow procedure for relief of symptoms or persistent obstruction. Complications were minimal. Con clusions: ESWL is a valuable adjunct in patients with impacted pancrea tic duct calculi unretrievable by primary endoscopic retrograde cholan giopancreatography.