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.

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

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

scholarly journals Safety and efficacy of digital single-operator pancreatoscopy for obstructing pancreatic ductal stones

2019 ◽  
Vol 07 (07) ◽  
pp. E896-E903 ◽  
Author(s):  
Olaya I. Brewer Gutierrez ◽  
Isaac Raijman ◽  
Raj J. Shah ◽  
B. Joseph Elmunzer ◽  
George J.M. Webster ◽  
...  
Keyword(s):  
Combined Treatment ◽  
The United States ◽  
Laser Lithotripsy ◽  
Technical Failure ◽  
Single Session ◽  
Technical Success ◽  
Safety And Efficacy ◽  
Single Operator ◽  
Pancreatic Duct Stones

Abstract Background and study aims The role of the digital single-operator pancreatoscopy (D-SOP) with electrohydraulic (EHL) or laser lithotripsy (LL) in treating pancreatic ductal stones is unclear. We investigated the safety and efficacy of D-SOP with EHL or LL in patients with obstructing pancreatic duct stones. Patients and methods Retrospective analysis of 109 patients who underwent D-SOP for pancreatic stones at 17 tertiary centers in the United States and Europe from February 2015 to September 2017. Logistic regression was performed to identify factors associated with the need for more than one D-SOP with EHL/LL. Results Most patients were males (70.6 %),mean age 54.7 years. Fifty-nine (54.1 %) underwent EHL and 50 (45.9 %) underwent LL. Mean procedure time was longer in the EHL group (74.4 min vs 53.8 min; P < 0.001). Ducts were completely cleared (technical success) in 89.9 % of patients (94.1 % in EHL vs 100 % in LL; P = 0.243), achieved in a single session in 73.5 % of patients (77.1 % by EHL and 70 % by LL; P= 0.5).D-SOP failed in 11 patients (10.1 %); 6 patients were treated with extracorporeal shockwave lithotripsy (ESWL), 1 with surgery,1 with combined treatment (ESWL + D-SOP EHL) and 3 with other. Fourteen adverse events occurred in 11 patients (10.1 %). Patients with more than three ductal stones were more likely to have technical failure compared to those with less than three stones (17 % vs. 4.8 %; P = 0.04). Having more than three stones was independently associated with the need for more than one D-SOC EHL/LL session (OR 2.94, 95 % CI 1.13 – 7.65). Conclusion D-SOP with EHL or LL is effective and safe in patients with pancreatic ductal 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 The feasibility of pancreatic duct stenting using a novel 4-Fr plastic stent with a 0.025-in. guidewire

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazumasa Nagai ◽  
Atsushi Sofuni ◽  
Takayoshi Tsuchiya ◽  
Kentaro Ishii ◽  
Reina Tanaka ◽  
...  
Keyword(s):  
Propensity Score ◽  
Pancreatic Duct ◽  
Propensity Score Matching ◽  
Statistical Significance ◽  
Control Group ◽  
Amylase Level ◽  
Technical Success ◽  
Plastic Stent ◽  
Technical Success Rate ◽  
Pancreatic Duct Stenting

AbstractPancreatic duct stenting is a well-established method for reducing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, there is no consensus on the optimal type of plastic stent. This study aimed to evaluate the feasibility and safety of a new 4-Fr plastic stent for pancreatic duct stenting. Forty-nine consecutive patients who placed the 4-Fr stent into the pancreatic duct (4Fr group) were compared with 187 consecutive patients who placed a conventional 5-Fr stent (control group). The primary outcome was technical success. Complications rate, including post-ERCP pancreatitis (PEP) were the secondary outcomes. Propensity score matching was introduced to reduce selection bias. The technical success rate was 100% in the 4Fr group and 97.9% in the control group (p = 0.315). Post-ERCP amylase level was significantly lower in the 4-Fr group than the control group before propensity score matching (p = 0.006), though without statistical significance after propensity score matching (p = 0.298). The rate of PEP in the 4Fr group (6.1%) was lower than the control group (15.5%), though without statistical significance before (p = 0.088) and after (p = 1.00) propensity score matching. Pancreatic duct stenting using a novel 4-Fr plastic stent would be at least similar or more feasible and safe compared to the conventional plastic stent.

scholarly journals Laser lithotripsy as a supplementary approach for the treatment of main pancreatic duct stones

2016 ◽  
Vol 83 (6) ◽  
pp. 1300-1301 ◽  
Author(s):  
Bai-Rong Li ◽  
Jun Pan ◽  
Liang-Hao Hu ◽  
Zhao-Shen Li
Keyword(s):  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Laser Lithotripsy ◽  
Pancreatic Duct Stones

scholarly journals Cadaveric Study of the Anatomical Variations of the Accessory Pancreatic Duct

2015 ◽  
Vol 9 (2) ◽  
pp. 83-88
Author(s):  
Sunjida Shahriah ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Fatema Johora ◽  
Dilruba Siddiqua ◽  
Shamim Ara
Keyword(s):  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Age Groups ◽  
Anatomical Variations ◽  
Pancreatic Ducts ◽  
Human Pancreas ◽  
Duodenal Papilla ◽  
Minor Duodenal Papilla ◽  
Accessory Pancreatic Duct ◽  
Bangladeshi Population

Background: The accessory pancreatic duct enters the duodenum at the minor duodenal papilla, developmentally draining the dorsal pancreatic bud; however, it is smaller and less constant than the main pancreatic duct and undergoes varying degrees of atrophy at the duodenal end. Objective: The objective of this study was to see the variations in course, opening and communication pattern of the accessory pancreatic duct in different age-groups in a Bangladeshi population. Methods: This crosssectional, descriptive study was done was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from August 2005 to December 2006, based on collection and dissection of 75 postmortem male human pancreas. The collected samples were divided into seven age groups: 10-19 years, 20-29 years,30-39 years, 40-49 years, 50-59 years),60-69 years and(eˆ70 years. However, 65 samples were taken for final observation. Results: The accessory pancreatic duct was found in 27.69% specimens. Straight course was found in 50% specimen, while spindle course in 27.78% and cudgel course in 22.22% specimens were observed. In only 4 (6.15%) specimens, the accessory pancreatic duct communicates with the common bile duct, while in 11 (16.93%) specimens, the accessory pancreatic duct communicates with the main pancreatic duct. 12 (66.67%) accessory pancreatic ducts opened into the minor duodenal papilla, while 5 (27.78%) into the major duodenal papilla and 1 (5.55%) into the 3rd duodenal papilla. Conclusion: Several variations were observed in accessory pancreatic duct pattern in terms of their course, opening and communications. However, no significant differences were evident in any parameter among the age groups. Here, females were excluded due to less availability of the female cadaveric pancreas during study period. DOI: http://dx.doi.org/10.3329/jbsp.v9i2.22802 Bangladesh Soc Physiol. 2014, December; 9(2): 83-88

scholarly journals Per-oral pancreatoscopy with intraductal lithotripsy for difficult pancreatic duct stones: a systematic review and meta-analysis

2020 ◽  
Vol 08 (10) ◽  
pp. E1460-E1470
Author(s):  
Thomas R. McCarty ◽  
Zain Sobani ◽  
Tarun Rustagi
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Pancreatic Duct ◽  
Meta Analysis ◽  
Safe Procedure ◽  
Technical Success ◽  
Stone Fragmentation ◽  
Significant Difference ◽  
Pancreatic Duct Stones ◽  
Per Oral

Abstract Background and study aims Per-oral pancreatoscopy (POP) with intraductal lithotripsy via electrohydraulic lithotripsy (EHL) or laser lithotripsy (LL) facilitates optically-guided stone fragmentation of difficult pancreatic stones refractory to conventional endoscopic therapy. The aim of this study was to perform a systematic review and meta-analysis to evaluate the efficacy and safety of POP with intraductal lithotripsy for difficult pancreatic duct stones. Methods Individualized search strategies were developed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines. This was a cumulative meta-analysis performed by calculating pooled proportions with rates estimated using random effects models. Measured outcomes included pooled technical success, complete or partial stone fragmentation success, complete duct clearance after initial lithotripsy session, and adverse events (AEs). Results Ten studies (n = 302 patients; 67.72 % male; mean age 55.10 ± 3.22 years) were included with mean stone size of 10.66 ± 2.19 mm. The most common stone location was in the pancreatic head (66.17 %). Pooled technical success was 91.18 % with an overall fragmentation success of 85.77 %. Single lithotripsy session stone fragmentation and pancreatic duct clearance occurred in 62.05 % of cases. Overall, adverse events were reported in 14.09 % of patients with post-procedure pancreatitis developing in 8.73 %. Of these adverse events, 4.84 % were classified as serious. Comparing POP-EHL vs POP-LL, there was no significant difference in technical success, fragmentation success, single session duct clearance, or AEs (P > 0.0500). Conclusions Based on this systematic review and meta-analysis, POP with intraductal lithotripsy appears to be an effective and relatively safe procedure for patients with difficult to remove pancreatic duct stones.

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