Guangchao Li et al., 2024: Multiple pancreaticobiliary fistulas combined with acute necrotizing pancreatitis: a rare complication of pancreatic extracorporeal shock wave lithotripsy

A patient is described in this article in whom SWL of large pancreatic calcifications were complicated by fistula to duodenum and the common bile duct. This seems to be a rare complication. The reason for development of fistula is unknown to the reviewer, but it can be speculated that high pressure in the pancreatic duct have played a major role. It seems wise in case of large pancreatic stone masses and risk of high pancreatic duct pressure to insert a stent before SWL. Hans-Göran Tiselius