Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2008
A minimally invasive alternative for managing large pancreatic duct stones using a modified expandable metal mesh stent.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Yang Xiu-Jiang, Lin Yong, Zeng Xin, Shi Jian, Chen Yue-Xiang, Shen Jian-Wei, Xie Wei-Fen
Аннотация
BACKGROUND AND AIM: Endoscopic clearance of large or impacted stones in the main pancreatic duct (MPD) remains a clinical challenge. In this study, we attempted to technically modify the metallic stent to facilitate the clearance of large pancreatic stones in 4 patients, hoping to lower the operative risks and shorten hospital stay.
PATIENTS AND METHODS: Four patients with chronic pancreatitis and large stones in the MPD received endoscopic treatment. Inclusion criteria were: (1) pancreatic intraductal stones (number >3; diameter >or=10 mm) and strictures identified in the distal MPD; (2) calculi mainly located in the head, neck and/or body of the pancreas, and (3) failed clearance of stones using a balloon catheter or Dormia basket. Before clearing the pancreatic calculi completely, a technically modified uncovered self-expandable metallic pancreatic stent was implanted in the MPD for 4-7 days to dilate the ductal stenosis, and then drawn out through the working channel.
RESULTS: As the MPD had been sufficiently expanded by the stent, the calculi were removed completely and uneventfully by the balloon or Dormia basket in all 4 patients, without inducing major postoperative complications. A 9- to 15-month follow-up did not find major complications or recurrence of large calculi in the MPD.
CONCLUSIONS: Technically modified metallic stenting is a minimally invasive and clinically feasible alternative to extracorporeal shock wave lithotripsy in the management of large pancreatic duct stones.
PATIENTS AND METHODS: Four patients with chronic pancreatitis and large stones in the MPD received endoscopic treatment. Inclusion criteria were: (1) pancreatic intraductal stones (number >3; diameter >or=10 mm) and strictures identified in the distal MPD; (2) calculi mainly located in the head, neck and/or body of the pancreas, and (3) failed clearance of stones using a balloon catheter or Dormia basket. Before clearing the pancreatic calculi completely, a technically modified uncovered self-expandable metallic pancreatic stent was implanted in the MPD for 4-7 days to dilate the ductal stenosis, and then drawn out through the working channel.
RESULTS: As the MPD had been sufficiently expanded by the stent, the calculi were removed completely and uneventfully by the balloon or Dormia basket in all 4 patients, without inducing major postoperative complications. A 9- to 15-month follow-up did not find major complications or recurrence of large calculi in the MPD.
CONCLUSIONS: Technically modified metallic stenting is a minimally invasive and clinically feasible alternative to extracorporeal shock wave lithotripsy in the management of large pancreatic duct stones.