Figure 3 Treatment by extracorporeal shock wave lithotripsy (ESWL) alone: decompression of the main pancreatic duct and restoration of the outflow of pancreatic juice into the duodenum (D–F) after ESWL, as compared with before (A–C) ESWL. Before treatment, (A) a single stone (arrow) is detected in the area of the head of the pancreas at abdominal plain film, (B) the main pancreatic duct is severely dilated and (C) no pancreatic juice appears in the duodenum after intravenous injection of secretin, as evidenced by magnetic resonance. After ESWL alone, (D) few stone fragments (arrowhead) are detected in the pancreatic area, (E) the main pancreatic duct is much thinner, and (F) pancreatic juice (in white) fills the duodenum shortly after intravenous injection of secretin.