2.4　ESWL Alone

In some patients，ESWL alone may be sufficient to achieve ductal decompression.Ohara et al.reported successful ductal clearance in 24 of 32 patients（75%），with subsequent pain relief in 79%of patients over 44 months（Ohara et al.1996）.Dumonceau et al.conducted a randomized study comparing ESWL alone and ESWL with endotherapy in 55 patients（Dumonceau et al.2007）.At 2 years follow-up，pain relief was seen in 38%and 45%，respectively.When effective，a shorter hospital stayand lower treatment cost may be possible by the approach of ESWL without ERCP.

Table 9.2　Pain relief after ESWL and endotherapy for chronic calcific pancreatitis(https://www.daowen.com)