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A Case of Pancreatolithiasis Treated by a Combination of Endoscopic Extraction and Extracorporeal Shock Wave Lithotripsy
Author(s) -
OKUSHIMA Kazumu,
NAKAZAWA Saburo,
YAMAO Kenji,
YOSHINO Junji,
INUI Kazuo,
YAMACHIKA Hitoshi,
KANEMAKI Naoto,
IWASE Teruhiko,
KISHI Katsuhiko,
FUJIMOTO Masao,
WATANABE Masumi,
HIRANO Ken,
HARADA Kou,
MIYOSHI Hironao,
NIMURA Yuji
Publication year - 1992
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1992.tb00112.x
Subject(s) - medicine , extracorporeal shock wave lithotripsy , lithotripsy , pancreatitis , surgery , extracorporeal , pancreatic duct , sedation , shock wave lithotripsy , fluoroscopy , endoscopic retrograde cholangiopancreatography , radiology
We report on the case of a 50‐year‐old woman with idiopathic chronic calcifying pancreatitis and diabetes. An endoscopic retrograde pancreatography showed a stone with a diameter of 23 mm and multiple small stones in the head of the pancreas. An endoscopic pancreatic sphincterotomy was performed. However, the stone could not be removed endoscopically. So we performed an extracorporeal shock wave lithotripsy (ESWL) using a Tripter X 1. The stone was located in the shock wave focus by fluoroscopy. Under intravenous sedation, the patient received 5 ESWL sessions (a total of 11700 shock waves with an energy of 18kv). ESWL permitted stone disintegration and successful endoscopic extraction of the fragments. Complete clearance in the main pancreatic duct was achieved. No severe complications were observed. After treatment, an improvement in the PFD test was seen. ESWL is an effective method for treatment of endoscopically unextractable pancreatic ductal stones.