A novel basket catheter to facilitate endoscopic removal of pancreatic stones (with video).
BACKGROUND
Endoscopic removal of pancreatic stones in patients with chronic pancreatitis is still challenging. With a conventional basket catheter, introduction to the target area or catching pancreatic stones is sometimes difficult.


OBJECTIVE
To evaluate a novel double-lumen basket catheter composed of nitinol wires with fine reticular structures in the distal end and loose mesh in the proximal part.


METHODS
A prospective feasibility study.


METHODS
Tertiary-care center.


METHODS
This study involved 10 patients with main pancreatic duct stones of 5 mm or less in the shorter diameter of the largest stone.


METHODS
In the first 5 cases, a nitinol basket catheter was used as salvage after stone extraction with a conventional basket catheter and retrieval balloon (salvage group). In the following 5 cases, stones were initially removed by using a nitinol basket catheter, and the presence of residual stones was evaluated by pancreatogram along with balloon sweep (initial group).


METHODS
Success rate of removal of the target stones and procedure-related adverse events.


RESULTS
A nitinol basket catheter was easily introduced to the target stone in all patients. In the salvage group, additional stones were retrieved with a nitinol basket catheter in 3 of 5 patients. In the initial group, stone extraction by a nitinol basket catheter was successful, and no residual stones were extracted by additional balloon cleaning in any patients. Basket impaction or after-ERCP pancreatitis was not observed.


CONCLUSIONS
A small sample size without a control group.


CONCLUSIONS
This novel nitinol basket catheter is useful for the extraction of small pancreatic stones. A randomized, controlled trial is warranted to confirm its efficacy.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Naoki
N
Sasahira
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hiroyuki
H
Isayama
Research and Development Center, Piolax Medical Devices Inc, Kanagawa, Japan.
Yoshihide
Y
Tokyokawa
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Suguru
S
Mizuno
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kenji
K
Hirano
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Yousuke
Y
Nakai
Research and Development Center, Piolax Medical Devices Inc, Kanagawa, Japan.
Risa
R
Sase
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hirofumi
H
Kogure
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Takashi
T
Sasaki
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Natsuyo
N
Yamamoto
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Minoru
M
Tada
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kazuhiko
K
Koike
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002137:Calculi / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D057785:Catheters; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts; D050500:Pancreatitis, Chronic / Q000150:complications*; D011859:Radiography
ESWL; MPD; extracorporeal shockwave lithotripsy; main pancreatic duct