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Extracorporeal shock wave lithotripsy (ESWL) was first utilized for fragmenting renal stones. Its therapeutic benefit was soon extended to biliary and pancreatic calculi. For over two decades, it has been used to fragment and clear large pancreatic duct (PD) calculi. To a lesser extent, it has also been used for fragmenting large bile duct and intrahepatic calculi not amenable to extraction by other available techniques.1-7 In this journal, Khan et al.8 have published data on efficacy and safety of ESWL for large common bile duct (CBD) and PD calculi. Of the 40 patients with large CBD stones, 37 patients had complete clearance and the others were subjected to surgery. All the 21 patients with chronic calcific pancreatitis (CCP) had complete clearance. Complications were minimal and mild in both these types of calculi. The authors found no significant factors that influence fragmentation. Follow-up for a short period showed good pain relief. This has been the experience of all centers that use ESWL for pancreatic and biliary calculi. Though the numbers in this study are not large, such work is to be encouraged as CCP is widely prevalent in our country.

ESWL—The Shocks are Beneficial