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ENDOSCOPIC PANCREATIC SPHINCTEROTOMY PLUS LARGE‐BALLOON DILATION FOR REMOVAL OF A LARGE IMPACTED PANCREATIC DUCT STONE (WITH VIDEO)
Author(s) -
Itoi Takao,
Kurihara Toshio,
Sofuni Atsushi,
Itokawa Fumihide,
Tsuchiya Takayoshi,
Ishii Kentaro,
Tsuji Shujiro,
Ikeuchi Nobuhito,
Umeda Junko,
Moriyasu Fuminori,
Sakai Yoshihiro
Publication year - 2010
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2010.01029.x
Subject(s) - medicine , pancreatic duct , pancreatitis , balloon dilation , complication , endoscope , balloon , acute pancreatitis , surgery , epigastric pain , radiology , vomiting
Pancreatic duct stones are a common complication of chronic pancreatitis. We describe successful endoscopic removal of a large pancreatic duct stone using large‐balloon dilation in combination with pancreatic sphincterotomy. A 63‐year‐old woman was admitted for endoscopic treatment of acute on chronic pancreatitis with diabetes and epigastric pain with liver dysfunction due to a large impacted stone within the distal main pancreatic duct. Endoscopic pancreatic sphincterotomy was carried out using a wire‐guided pull‐type sphincterotome. Although we could carry out a relatively large incision, the stone could not be extracted. We therefore carried out papillary dilation using a large balloon (diameter 12 to 15 mm) to make room alongside the stone. A 10 × 20‐mm white pancreatic duct stone was extracted during the process of pulling a dilating balloon into the working channel of the endoscope. Eventually, the second stone was removed without any procedure‐related complication.