title: Temporary placement of a fully covered self-expandable metal stent in the pancreatic duct for aiding extraction of large pancreatic duct stones: preliminary data.
abstract: OBJECTIVE
  Endoscopic clearance of large stones in the pancreatic duct (PD) is very difficult, even in patients undergoing stone fragmentation by extracorporeal shock wave lithotripsy. Placement of fully covered self-expandable metal stents (FCSEMSs) has not yet been reported to aid extraction of large PD stones. This aim of this study is to evaluate the technical success and safety of temporary placement of a FCSEMS in the PD to aid extraction of large PD stones.
  
  
  METHODS
  Here, we report a pilot study and retrospective case series. Eight patients with chronic pancreatitis and large stones in the PD received endoscopic treatment. Eight symptomatic patients with more than three PD stones of large diameter (≥10 mm) were selected for FCSEMS placement and participation in this study. The patients' PD stones were located in the head, neck, and/or body of the pancreas and could not be cleared using a balloon catheter and basket. After placement of a FCSEMS (10 mm diameter) in the PD between 1 and 5 months (mean duration: 71 days), standard endoscopic maneuvers led to clearance of large PD stones. Technical success was defined as successful stent placement and the ability to achieve PD clearance in two endoscopic sessions. Complications were assessed according to consensus criteria.
  
  
  RESULTS
  FCSEMSs were placed successfully in all patients and PD stones were all cleared easily from the dilated PD using the retrieval balloon and basket. There were no significant complications such as acute pancreatitis, hemorrhage, migration, or stent incarceration. At the 6-month follow-up, no residual stones were observed on pancreatography, and all patients were doing well, without any symptom recurrence.
  
  
  CONCLUSIONS
  Temporary placement of an FSCEMS in the PD is a minimally invasive and feasible approach for aiding extraction of large PD stones.
authors.affiliation: Department of Gastroenterology, General Hospital of Chinese PLA, Beijing, People's Republic of China.
authors.forename: Zhichu
authors.initials: Z
authors.lastname: Qin
authors.forename: En-Qiang
authors.initials: EQ
authors.lastname: Linghu
mesh_terms: D000328:Adult; D002137:Calculi / Q000150:complications / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D010182:Pancreatic Diseases / Q000601:surgery*; D010183:Pancreatic Ducts / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000209:etiology / Q000601:surgery; D010865:Pilot Projects; D012189:Retrospective Studies; D015607:Stents; D055815:Young Adult
chemical_list: D008670:Metals