Jagtap N. et al., 2020: Extracorporeal Shock Wave Lithotripsy for Pancreaticolithiasis: Do It Now

Literature data show that SWL has become increasingly popular among gastroenterologists for treating patients with pancreatic stones. The current Letter is a comment to a previously published article [1]. The authors compare this report with their own experience. The advice given in the Letter is to administer a larger number of shockwaves: 5000-6000 [2]. It is, however, uncertain whether an increased number of shockwaves really results in improved disintegration of the usually brittle pancreatic stones. The fact that the same technician carried out SWL during the two periods reported in [1] does not necessarily mean that SWL was completed in an identical way. The fundamental point is that SWL should be carried out in an individualised way and in this regard, I assume that differences might be explained by how the treatments were overlooked and controlled by the responsible surgeons based on their specific experience. The bottom-line is, however, that SWL has an important and given place in the treatment of pancreatic stones, particularly the more difficult ones. References 1. Jaben et al. Comparison of Urologist- vs Gastroenterologist-Directed Extracorporeal Shock Wave Lithotripsy for Pancreaticolithiasis. Clin Gastroenterol Hepatol. 2020 Jul 23;S1542-3565(20)31004-1. doi: 10.1016/j.cgh.2020.07.042. Online ahead of print. 2. Tadan M et al. ESWL for large pancreatic calculi: Report of over 5000 patients. Pancreatology 2019; 19:916-921. doi: 10.1016/j.pan.2019.08.001. Epub 2019 Aug 2.PMID: 31447280 Hans-Göran Tiselius