Related Experiment Video
Updated: Aug 20, 2026
Treatment Protocol for Rotator Cuff Calcific Tendinitis Using a Single-Crystal Piezoelectric Focused Shock Wave Source
Published on: December 23, 2022
Extracorporeal shock wave lithotripsy in the management of chronic calcific pancreatitis: a meta-analysis
Nalini M Guda1, Susan Partington, Martin L Freeman
1Gastroenterology Division, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN 55415, USA.
Context:
Main pancreatic duct stones may contribute to pain in chronic pancreatitis. Extracorporeal shock wave lithotripsy (ESWL) has been used alone or in combination with endoscopic therapy for fragmentation of stones. Published studies have shown mixed efficacy due to small sample size.
Objective:
Systematic analysis of all published data evaluating ESWL with or without endoscopic therapy in pancreatic duct clearance and symptom relief.
Methods:
Two investigators independently reviewed the computer databases. 31 potential studies were identified. Only studies using ESWL with or without endoscopic therapy were included. Completeness of the search was confirmed by an expert. Studies were independently coded by two investigators and differences rectified by mutual consent.
Main Outcome Measures:
Pain at follow-up and duct clearance.
Results:
Seventeen studies published between 1989 and 2002 were included. Sixteen had a measure of pain at follow-up and duct clearance. All studies were case series with a total of 588 subjects, and included varying number of subjects undergoing endoscopic pancreatic sphincterotomy and stone extraction. The mean effect size (weighted correlation coefficient) for pain was 0.6215 and for duct clearance was 0.7432; thus indicating a large effect. All studies showed homogeneity suggesting similar effect size irrespective of the combinations of therapy.
Conclusions:
ESWL is effective in clearance of stones from the pancreatic duct and in relief of pain. Published studies showed homogeneity of the effect size of ESWL both in pancreatic duct clearance and relief of pain.
Related Concept Videos
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:25Urinary Tract Calculi VI: Surgical Management
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:25Chronic Pancreatitis I: Introduction
01:30Urinary Tract Calculi III: Medical Management