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A 50-year-old man was referred for evaluation of alcohol-related chronic relapsing pancreatitis. Initial endoscopic retrograde cholangiopancreatography (ERCP) revealed a dilated pancreatic duct with a stone proximal to a distal stricture. The stricture was dilated to 6mm using a balloon, and an 8.5-Fr plastic stent was placed to ensure drainage. ERCP 2 months later showed no improvement in the stricture and a 10-Fr stent was placed. Repeat pancreatography 2 months later (▶Video1) revealed a persistent distal stricture with a floating ovoid-shaped stone (6×10mm) in the proximally dilated duct (▶Fig. 1 a). The stricture was dilated to 6mm (▶Fig. 1b), and an 8mm× 4cm fully covered Gore Viabil (Conmed Corp., Utica, New York, USA) self-expandable metallic stent (SEMS) was placed across the stricture. A rat-tooth forceps was passed through the SEMS and the stone was grasped (▶Fig. 2) under fluoroscopic guidance. The stone and stent were then simultaneously extracted from the duct and removed from the patient (▶Fig. 3, ▶Video1). There were no post-procedural complications. Ductal hypertension, as a result of obstruction from pancreatic duct stones and strictures in chronic pancreatitis, is believed to be the major cause of pain and recurrent pancreatitis [1]. Treatment options for pancreatolithiasis vary depending on stone location and size [2, 3]. The 2015 European Society of Gastrointestinal Endoscopy recommends the use of ERCP as first-line therapy in patients with a small number of stones with a diameter of < 5mm in the body E-Videos

Self-expandable covered metallic stent as a conduit for pancreatic stone extraction