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Electrohydraulic Lithotripsy for Pancreatic Duct Stones Under Digital Single-Operator Pancreatoscopy (with Video)

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Abstract

Background

Recently, a digital single-operator cholangiopancreatoscope (DSOC) has become available. This system allows the performance of electrohydraulic lithotripsy (EHL) even within the main pancreatic duct (MPD). However, there are only few reports of EHL for MPD stones using SPY-DS.

Aims

The aim of this study was to evaluate the technical feasibility and efficacy of EHL for MPD stones under DSOC guidance.

Methods

Between October 2016 and August 2017, patients with MPD stones were retrospectively enrolled in this study. The presence of MPD stones was diagnosed by endoscopic ultrasound and MRCP. The patients’ baseline characteristics and those of the stones, including their size, number, and site in the MPD, number of EHL procedures, and adverse events, were reviewed.

Results

A total of 21 patients were retrospectively enrolled. The etiologies of chronic pancreatitis were idiopathic (n = 4) and alcohol induced (n = 17). The pancreatic stone was variously located in the head (n = 6), body (n = 11), tail (n = 1), head and body (n = 2), and body and tail (n = 1) of the pancreas. Median pancreatic stone size was 12 mm, and the mean number of ERCP sessions was 1.29 (range 1–3). EHL was successfully performed in 15 patients (85.7%, 18/21), and the rate of complete stone clearance was 88.2% (18/21). Severe adverse events were not seen in any of the patients, although one patient developed mild acute pancreatitis.

Conclusions

In conclusion, although additional case reports and prospective studies are needed, EHL under DSOC may be an option to treat MPD stones.

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Authors and Affiliations

  1. 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakuchou, Takatsukishi, Osaka, 569-8686, Japan

    Takeshi Ogura, Atsushi Okuda, Miyuki Imanishi, Akira Miyano, Mio Amano, Nobu Nishioka, Rieko Kamiyama & Kazuhide Higuchi

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  1. Takeshi Ogura
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  2. Atsushi Okuda
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  3. Miyuki Imanishi
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  4. Akira Miyano
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  5. Mio Amano
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  6. Nobu Nishioka
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  7. Rieko Kamiyama
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  8. Kazuhide Higuchi
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Contributions

Takeshi Ogura wrote a paper. Takeshi Ogura, Atsushi Okuda, Miyuki Imanishi, Akira Miyano, Mio Amano, Nobu Nishioka, Rieko Kamiyama, and Kazuhide Higuchi played roles of interpretation of data for the work, revising it critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Takeshi Ogura.

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The authors declare that they have no conflicts of interest.

Electronic supplementary material

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Supplementary material 1: Endoscopic lithotripsy was performed under SPY-DS guidance, resulting in successful fragmentation of the stone. (AVI 14513 kb)

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Ogura, T., Okuda, A., Imanishi, M. et al. Electrohydraulic Lithotripsy for Pancreatic Duct Stones Under Digital Single-Operator Pancreatoscopy (with Video). Dig Dis Sci 64, 1377–1382 (2019). https://doi.org/10.1007/s10620-018-5374-z

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  • DOI: https://doi.org/10.1007/s10620-018-5374-z

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