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Plastic stent placement under endoscopic retrograde cholangiopancreatography is performed widely for the treatment of benign pancreatic stricture [1]. However, this techniquemay have several disadvantages such as short stent patency and persistent stricture compared with fully covered metallic stents (FCMS) [2,3]. Therefore, although FCMS placement for benign pancreatic stricture is still controversial as a result of a relatively high rate of stent migration (especially distal migration), the FCMS has a potential clinical impact in patients with symptomatic chronic pancreatitis. This report describes the placement of a novel FCMS (6mm×6cm, Niti-S Biliary S-Type Stent Long Suture; TaeWoong Medical, Seoul, Korea; Century Medical Inc., Tokyo, Japan) in patients with chronic pancreatitiswho have refractory pancreatic duct stricture (●" Fig.1). This novel FCMShas a long removal suture, and therefore, if distal stent migration doesoccur, the stent can be removedeasily by grasping the suture thread. A 66-year-old man was admitted to the Osaka Medical College Hospital with abdominal pain caused by pancreatic stent occlusion. He had undergone placement of a 10-Fr plastic stent 1 month earlier for pancreatic duct stricture caused by chronic pancreatitis. Despite several stent exchanges, the pancreatic duct stricture persisted. Therefore, it was decided to place a novel FCMS. First, the plastic stent was removed, and contrast medium was injected into the main pancreatic duct. A pancreatic duct stricture of the pancreatic head was seen (●" Fig.2). Next, the novel metallic stent delivery system (8Fr) was inserted through the stenosis site (●" Fig.3), and the stent was successfully placed (●" Fig.4, ●" Video 1). No adverse events occurred and the patient was discharged. After 6 months, no late adverse events, including stent migration, were observed. This stent may be a safer device because if the stent migrates it can be retrieved easily by grasping the long suture thread. However, results from a prospective study with long term follow-up are needed to confirm this.

Placement of a novel fully covered metallic stent for refractory pancreatic duct stricture