Abstract: Objective To evaluate the efficacy of ESWL combined with ERCP for the treatment of pancreatic duct stones (PDSs).Methods 12 patients with PDSs confirmed by ultrasound and radiography received treatment in our hospital from January 2008 to March 2010.ERCP was first performed to determine the ductal morphology,the location and number of stones,which pancreatic sphincterotomy and stenting were performed depending on the condition of the patients.ESWL was performed in all patients and repeated depending on stone changes.6-8 weeks after ESWL,therapeutic ERCP for balloon dilation and stone extraction was performed to manage residual stones.Pancreatic stents were placed after stone extraction.Results ESWL was performed and stone fragmentation was achieved in all patients.Spontaneous stone clearance after ESWL alone occurred in one patient.Complete duct clearance was achieved in 7 patients by therapeutic ERCP; partial duct clearance was achieved in one patient; and duct clearance failed in one patients.Of the 12 patients,two patients failed to follow-up after ESWL.No procedure-related major complication occurred.Conclusions ESWL is effective for PDS fragmentation and can be repeated.A high rate of successful PDS clearance can be achieved when therapeutic ERCP is followed by ESWL

Key words: Pancreatic duct stone, Extracorporeal shock wave lithotripsy, Endoscopic retrograde cholangiopancreatography