Abstract
We examined recurrence and exocrine function for pancreatolithiasis after treatment with extra-corporeal shockwave lithotripsy (ESWL), and occasional interventional endoscopy, in 100 mostly male patients aged 22 to 78 years. Etiology was alcohol-related in 73, and idiopathic in 20 cases. Stone fragmentation was achieved in all. Complete clearance was the objective. Non-alcohol etiology and stones in region 1 favored clearance. During 1 to 236 follow-up months, 32 patients had recurrence, at a mean of 16.3 months. Recurrence (within 1 year) was high in patients with strictures (46%), while later recurrence was high in patients with alcohol-related etiology (30%). In 64 serially tested patients, functions improved or remained unchanged in 45 (70%). Among 27 patients tested after 1 year, function was improved or unchanged in 17 (63%). Ductal strictures and absence of pancreatic atrophy favored long-term function. ESWL and interventional endoscopy should be a first-choice of treatment. ESWL can be a first-choice treatment for patients with non-alcohol etiology and stones in region 1.
