4691 Shock wave lithotripsy with a piezo-electric lithotriptor in the management of chronic pancreatitis.

Aim: pancreatic stones are frequently reported to be a factor of failure of endoscopic treatment of chronic pancreatitis. Our series tried to evaluate the efficacy of extracorporeal piezoelectric shock wave lithotripsy (ESWL) to disintegrate pancreatic stones in the main pancreatic duct. Methods- Patients: 51 patients (40 men, 11 women) with a mean age of 51 years, presenting with chronic pancreatitis, have been treated between May 1995 to January 1990. The mean number of sessions of lithotripsy was 4.96 per patient with the piezoelectric lithotriptor EDAP LT02. The mean cumul (power (%) x time (sec) x frequency (shock/sec.) /160) per patient was 70,5 +/- 40,5. The total or uncomplete success was defined by the feasibility ofpancreatic stenting. Results: The fragmentation of stones in the main pancreaticduct was achieved in 83,3 % of cases. The total success was achievedin 25 patients (49%), an uncomplete succcess in 11 patients (21%) and atotal failure in 15 patients (29%). Pancreatic stenting failed in 3/33patients after the ESWL and 10/33 patients before the ESWL. Pain disappearedin 72% of the cases after ESWL. There was a significant relationbetween the fragmentation of stones and the disappearance of pain. A significantrelationship was shown between the cumul value and the fragmentationrate. Conclusion: ESWL with the piezoelectric lithotriptor provides satisfactory results on the disappearance of the pain and on the fragmentation. ESWL seems helpful in the endoscopic treatment of chronic pancreatitis.