A Case of Pancreatolithiasis Treated by Extracorporeal Shock Wave Lithotripsy (ESWL) with Endoscopic Naso Pancreatic Drainage (ENPD)

Abstract

A 67-year-old male who followed up for alcoholic chronic pancreatitis admitted with abdominal pain in another hospital. This patient was transferred to our hospital for treatment of pancreatolithiasis after emergency percutaneous transhepatic pancreatic cyst drainage to be detected pancreatolithiasis and pancreatic cyst on abdominal US and CT. ESWL was performed due to pancreatography through percutaneous transhepatic pancreatic cyst drainage tube showed MPD dilatation and pancreatolithiasis in the pancreas head.
Post ESWL pancreatography through percutaneous transhepatic drainage tube showed several fragmented stones in the pancreatic duct. To extract percutaneous transhepatic drainage tube safely, ENPD was performed. Percutaneous transhepatic drainage tube extracted two weeks later after clamp. The day after, pancreatography of ENPD tube showed several fragmented stones in the pancreatic duct. Therefore, endoscopic extraction of remaining stones were performed. It is no recurrence for ten monthes after.