A partial or total absence of stones in pancreaticolithiasis therapy can be
reached by using ESWL. We report on a patient who happened to get an incar
ceration of a fragment in the distal pancreatic duct after having been trea
ted by ESWL without a previous sphincterotomy to the ductus Wirsungianus. T
his emphasizes the recommendation to carry out a papillotomy of the pancrea
tic main duct before applying ESWL to pancreatic stones.