An unusual complication in attempted non-surgical treatment of pancreatic bile duct stones.
This report describes a guidewire fracture during an attempt at endoscopic treatment of pancreatic duct calculi in a patient with chronic pancreatitis, multiple pancreatic duct stenoses and pancreatic duct stones. This patient underwent endoscopic sphincterotomy in order to perform pancreatic duct drainage prior to ESWL. After sphincterotomy, a guidewire was introduced into the main pancreatic duct, but was jammed by the calculi. Neither could the guidewire be removed nor a contrast medium catheter be pushed over it, thus making ESWL impossible. A stronger pull resulted in a fracture of the wire, and a 25 mm long part which could not be removed with a Dormia basket remained in the main pancreatic duct. A Whipple's procedure became necessary as definitive treatment for the pancreatico-lithiasis in this patient.
Surgical Department I, Ludwig-Boltzmann-Institute for Experimental and Gastroenterological Surgery, Landeskrankenanstalten Salzburg, Austria.
M
M
Heinerman
R
R
Mann
O
O
Boeckl
D000328:Adult; D002137:Calculi / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy; D008297:Male; D010182:Pancreatic Diseases / Q000628:therapy*; D010183:Pancreatic Ducts; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects*