Pilot study of pancreatoscopic lithotripsy using a 5-fr instrument: selected patients may benefit.
OBJECTIVE
Despite advances in endoscopic procedures and extracorporeal shock wave lithotripsy (ESWL), the removal of impacted pancreatic duct stones demands a certain amount of time. The aim of this study was to determine which patient group might suitable for our single-session treatment.


METHODS
The study included 17 patients who were symptomatic due to relapsing pancreatitis with pancreatic duct stones. A 5-Fr miniscope was inserted via the papilla to the impacted pancreatic duct stone and pancreatoscopic laser lithotripsy (PSLL) was performed, under direct vision, in only one session. If complete extraction of the pancreatic duct stones was not achieved with PSLL, ESWL was adopted in subsequent sessions.


RESULTS
Complete extraction of the pancreatic duct stones using PSLL in a single session was achieved in eight of 17 patients. Single-session PSLL was only suitable for patients with pancreatic duct stones smaller than 17 mm in diameter and with no severe stricture or sharp bend in the pancreatic duct proximal to the stones.


CONCLUSIONS
Our single-session endoscopic treatment of pancreatic duct stones was useful in a selected patient group.
Second Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Japan.
T
T
Hirai
H
H
Goto
Y
Y
Hirooka
A
A
Itoh
S
S
Hashimoto
Y
Y
Niwa
T
T
Hayakawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D005260:Female; D006801:Humans; D020347:Lithiasis / Q000628:therapy*; D017602:Lithotripsy, Laser / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000628:therapy*; D010183:Pancreatic Ducts / Q000473:pathology; D018579:Patient Selection; D010865:Pilot Projects; D016896:Treatment Outcome