Open AccessTranspapillary incision of refractory circumscript pancreatic duct stricture using wire-guided snare forceps
Author(s) -
Takao Itoi,
Atsushi Sofuni,
Fumihide Itokawa,
Toshio Kurihara,
Takayoshi Tsuchiya,
Kentaro Ishii,
Shujiro Tsuji,
Nobuhito Ikeuchi,
Fuminori Moriyasu
Publication year - 2010
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v16.i12.1541
Subject(s) - medicine , pancreatic duct , pancreatitis , surgery , refractory (planetary science) , balloon dilation , forceps , duct (anatomy) , radiology , balloon , physics , astrobiology
Endoscopic therapy of pancreatic duct (PD) strictures using balloon dilation and pancreatic duct stent (PS) placement has been reported to improve the severity of abdominal pain in selected patients with chronic pancreatitis (CP). However, some strictures are refractory and require frequent PS exchange to control symptoms. We describe two cases of successful endoscopic PD incision for difficult PD stricture using a wire-guided snare. The snare is partially opened within the strictured pancreatic duct while applying current, thus incising the duct. Although both cases were successful without complications we do not advocate that this method be used routinely because of the potential for severe complications, e.g. bleeding, ductal perforation or pancreatic parenchymal damage. In order to prevent these complications, we developed a wire-guided technique under fluoroscopic control. We think this procedure may be useful in patients with short, straight PD strictures. Although further study is required, this approach may have potential for selected patients with refractory PD strictures due to CP.