| Theme |
Chronic Pancreatitis |
| Title |
Endoscopic Lithotripsy and Extracorporeal Shock-wave Lithotripsy for Pancreatolithiasis |
| Author |
Satoshi Yamamoto |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University |
| Author |
Kazuo Inui |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University |
| Author |
Junji Yoshino |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University |
| Author |
Hironao Miyoshi |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University |
| Author |
Takashi Kobayashi |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University |
| [ Summary ] |
We review endoscopic pancreatic sphincterotomy, endoscopic minor papilla sphincterotomy, and extracorporeal shock-wave lithotripsy (ESWL), as non-surgical treatments for pancreatolithiasis. In principle, these treatments for pancreatolithiasis are indicated for patients with abdominal pain, not for asymptomatic patients. However, we sometimes performed these treatments for asymptomatic patients with dilation of the distal pancreatic duct, due to impacted pancreatic stones and without atrophy of the pancreatic parenchyma. This was because pancreatic exocrine function could be preserved in such patients. We usually performed ESWL for most patients with pancreatolithiasis. On the other hand, endoscopic treatment is useful for patients with small stones, less than 5-6 mm in diameter, floating or radiopaque stones. Procedures for non-surgical treatment of pancreatolithiasis are established and recognized as valuable tools. However, non-surgical treatment for pancreatolithiasis in patients with strictures in the main pancreatic duct and/or pancreatic pseudocysts is a controversial issue. Because non-surgical treatment for these conditions has limitations, physicians should consider transitioning to surgical treatments at the first opportunity. |