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Extracorporeal shock wave lithotripsy and endoscopic pancreatic stenting without pancreatic sphincterotomy for the treatment of pancreatolithiasis: a case series

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Abstract

Endoscopic therapy and extracorporeal shock wave lithotripsy (ESWL) are recommended as the first choice in treating pancreatolithiasis. Endoscopic therapy is generally performed using endoscopic pancreatic sphincterotomy (EPST). Herein, we report our experience implementing a treatment protocol, combining endoscopic therapy and ESWL without EPST, for pancreatolithiasis. The inpatient treatment plan was performed every 3 months with a set number of sessions of ESWL with endoscopic pancreatic stenting (EPS) implanted or replaced. Finally, treatment was terminated when the stone was removed after implantation of a 10-Fr stent and crushed to approximately 3 mm or after spontaneous stone discharge. Eight patients were included in this study; the median time to stone disappearance was 208.5 days. The median number of inpatient treatment cycles, endoscopic retrograde cholangiopancreatography, and ESWL sessions was 2.5, 3, and 3, respectively. No serious adverse events were observed in all patients. Therefore, combining ESWL and EPS without EPST can safely treat pancreatolithiasis.

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Acknowledgements

There was no specific financial support. The case series was managed in a routine clinical context.

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Authors and Affiliations

  1. Department of Gastroenterology, Shizuoka General Hospital, 4-27-1, Kita-Ando, Aoi-Ku, Shizuoka-City, Shizuoka, 420-8527, Japan

    Shinya Endo, Shinya Kawaguchi, Tatsunori Satoh & Naofumi Shirane

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  1. Shinya Endo
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  2. Shinya Kawaguchi
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  3. Tatsunori Satoh
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  4. Naofumi Shirane
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Contributions

SE and SK contributed to the study conception and design. SE, SK, and TS examined and cared for the patient. Material preparation, data collection, and analysis were performed by SE. The first draft of the manuscript was written by SE and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Shinya Endo.

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All procedures followed were in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its subsequent amendments.

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Informed consent was obtained from all patients in this study.

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Endo, S., Kawaguchi, S., Satoh, T. et al. Extracorporeal shock wave lithotripsy and endoscopic pancreatic stenting without pancreatic sphincterotomy for the treatment of pancreatolithiasis: a case series. Clin J Gastroenterol 16, 615–622 (2023). https://doi.org/10.1007/s12328-023-01803-z

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  • DOI: https://doi.org/10.1007/s12328-023-01803-z

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