Pancreatoscopy-guided intracorporeal laser lithotripsy for difficult pancreatic duct stones: a case series with prospective follow-up (with video)

2013 ◽  
Vol 78 (1) ◽  
pp. 179-183 ◽  
Author(s):  
Abdullah Alatawi ◽  
Sarah Leblanc ◽  
Ariane Vienne ◽  
Carlos Alberto Pratico ◽  
Marianne Gaudric ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Case Series ◽  
Laser Lithotripsy ◽  
Pancreatic Duct Stones

Sa1498 Pancreatoscopy-Guided Laser Lithotripsy for Difficult Pancreatic Duct Stones. A Single Center Experience

2016 ◽  
Vol 83 (5) ◽  
pp. AB274
Author(s):  
Apostolos Malachias ◽  
Dimitrios Kypraios ◽  
Loukas Theodoropoulos ◽  
Stamatia-Lydia Hatzinicolaou ◽  
Stavros Stavrinides ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Laser Lithotripsy ◽  
Single Center ◽  
Single Center Experience ◽  
Pancreatic Duct Stones

Symptomatic pancreatic duct stones in the disconnected bile duct: A case series

Pancreatology ◽  
2017 ◽  
Vol 17 (1) ◽  
pp. 51-54
Author(s):  
Alexander R. Ende ◽  
Shayan Irani ◽  
Richard A. Kozarek
Keyword(s):  
Bile Duct ◽  
Pancreatic Duct ◽  
Case Series ◽  
Pancreatic Duct Stones

1060 Pancreaticoscopy-Guided Laser Lithotripsy Via Minor Papilla for Impacted Pancreatic Duct Stones

2017 ◽  
Vol 85 (5) ◽  
pp. AB131
Author(s):  
Sirilak Yooprasert ◽  
Phonthep Angsuwatcharakon ◽  
Rungsun Rerknimitr
Keyword(s):  
Pancreatic Duct ◽  
Laser Lithotripsy ◽  
Minor Papilla ◽  
Pancreatic Duct Stones

scholarly journals Initial results of new technological approach to visualization and treatment of bile and pancreatic duct disease

2019 ◽  
Vol 24 (2) ◽  
pp. 105-116
Author(s):  
S. A. Budzinskiy ◽  
S. G. Shapovalyants ◽  
E. D. Fedorov ◽  
D. V. Bakhtiozina ◽  
L. M. Mikhaleva ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Laser Lithotripsy ◽  
Pancreatic Ducts ◽  
Duodenal Papilla ◽  
Technical Success ◽  
Technical Success Rate ◽  
Pancreatic Duct Stones ◽  
Spyglass Ds ◽  
Complications And Mortality ◽  
Initial Results

Objective. To evaluate possibilities and advantages of SpyGlass DS system (Boston Scientific) in the diagnosis and treatment of pancreato-biliary diseases. Material and methods. SpyGlass DS has been applied in 24 interventions in 22 patients for the period from December 6, 2017 to July 6, 2018. There were 21 cholangioscopies, 2 pancreaticoscopies and one cholangiopancreaticoscopy. The indications for cholangioscopy were undifferentiated strictures (n = 14), suspected Mirizzi syndrome (n = 2), large choledocholithiasis and need for laser lithotripsy (n = 1). There was a need to pass a guidewire under visual control (n = 2) and to control bile duct stones extraction (n = 1). Scheduled removal of ligature after laparoscopic cholecystectomy was in 1 case. Indication for pancreaticoscopy was suspected malignancy within the strictures associated with chronic pancreatitis, for cholangiopancreaticoscopy – assessment of spread of major duodenal papilla tumor into common bile and pancreatic ducts. Results. Overall technical success rate was 95.8% (23/24). Intraductal biopsy was successfully performed in 13 out of 14 (92.9%) cases. Cholangiocarcinoma was histologically confirmed in 6 cases. Curative interventions were performed in all 4 cases. There were no complications and mortality. Conclusion. The main indications for endoscopic peroral intraductal interventions are various types of undifferentiated and complicated biliary and pancreatic strictures, as well as “difficult” bile and pancreatic duct stones. The technology of diagnostic and curative endoscopic interventions using the SpyGlass DS system is relatively simple while morbidity and mortality rates are similar to those after conventional transpapillary interventions.

scholarly journals Success of extracorporeal shock wave lithotripsy and ERCP in symptomatic pancreatic duct stones: a systematic review and meta-analysis

2020 ◽  
Vol 08 (08) ◽  
pp. E1070-E1085
Author(s):  
Nadine C.M. van Huijgevoort ◽  
Joyce V. Veld ◽  
Paul Fockens ◽  
Marc G. Besselink ◽  
Marja A. Boermeester ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shock Wave ◽  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Clearance Rate ◽  
Shock Wave Lithotripsy ◽  
Meta Analysis ◽  
Extracorporeal Shock Wave ◽  
Pancreatic Duct Stones

Abstract Background and study aims Pain is the most frequent and dominant symptom of chronic pancreatitis. Currently, these patients are treated using a step-up approach, including analgesics and lifestyle adjustments, endoscopic, and eventually surgical treatment. Extracorporeal shock wave lithotripsy (ESWL) is indicated after failure of the first step in patients with symptomatic intraductal stones larger than 5 mm in the head or body of the pancreas. To assess the complete ductal clearance rate and pain relief after ESWL in patients with symptomatic chronic pancreatitis with pancreatic duct stones, a systematic review and meta-analysis was performed. Patients and methods A systematic literature search from January 2000 to December 2018 was performed in PubMed, the Cochrane Library, and EMBASE for studies on ductal clearance rate of ESWL in patients with symptomatic chronic pancreatitis with pancreatic duct stones. Results After screening 486 studies, 22 studies with 3868 patients with chronic pancreatitis undergoing ESWL for pancreatic duct stones were included. The pooled proportion of patients with complete ductal clearance was 69.8 % (95 % CI 63.8–75.5). The pooled proportion of complete absence of pain during follow-up was 64.2 % (95 % CI 57.5–70.6). Complete stone fragmentation was 86.3 % (95 % CI 76.0–94.0). Post-procedural pancreatitis and cholangitis occurred in 4.0 % (95 % CI 2.5–5.8) and 0.5 % (95 % CI 0.2–0.9), respectively. Conclusion Treatment with ESWL results in complete ductal clearance rate in a majority of patients, resulting in absence of pain during follow up in over half of patients with symptomatic chronic pancreatitis caused by obstructing pancreatic duct stones.

scholarly journals Antegrade pancreatoscopy via EUS-guided pancreaticogastrostomy allows removal of obstructive pancreatic duct stones

2018 ◽  
Vol 06 (06) ◽  
pp. E735-E738 ◽  
Author(s):  
Theodore James ◽  
Todd Baron
Keyword(s):  
Pancreatic Duct ◽  
Clinical Success ◽  
Laboratory Data ◽  
Pancreatic Head ◽  
Clinical Success Rate ◽  
Electrohydraulic Lithotripsy ◽  
Clinical Scenarios ◽  
Novel Method ◽  
Pancreatic Duct Stones

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is an effective treatment for pancreaticolithiasis, including use of pancreatoscopy for intraductal electrohydraulic lithotripsy (IEHL). Pancreatoscopy is often limited by a small-caliber downstream pancreatic duct as well as an unstable pancreatoscope position within the pancreatic head. Endoscopic ultrasound-guided pancreaticogastrostomy (EUS-PG) has been developed as a method to relieve ductal obstruction when retrograde access fails. The current study describes pancreatoscopy via EUS-PG, a novel method for managing obstructing pancreaticolithiasis. Patients and methods From September 2017 to January 2018, patients who underwent EUS-PG followed by antegrade pancreatoscopy via PG were identified. Endoscopy reports, medical charts and relevant laboratory data were reviewed and recorded. Results Five patients underwent EUS-PG and antegrade pancreatoscopy via PG during the study period; clinical success rate was 100 %. There were no significant adverse events during the procedure or follow up period. Conclusions Pancreatoscopy via PG for IEHL is safe and effective for treating obstructing pancreaticolithiasis in patients who have previously failed ERCP or in clinical scenarios were ERCP is not possible.

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