Profitable endoscopic removing of a uncommon, massive impacted pancreatic duct stone utilizing greedy forceps: A case report with video.
Drugs (Baltimore). 2018 Apr;97(14):e0304
Authors: Liu Q, Wang Y, Zeng H, Hu B
RATIONALE: As a essential complication of continual pancreatitis (CP), pancreatic duct stones (PDSs) are sometimes related to ductal obstruction leading to rising intraductal and parenchymal stress and long-lasting ache. There are a lot of strategies for eradicating PDSs. Nevertheless, for giant stones, it’s technically tough to take away them solely by endoscopic retrograde cholangiopancreatography (ERCP).
PATIENT CONCERNS: A 57-year-old man introduced with a chief grievance of extreme epigastric ache radiating to his again three or four instances yearly for two years.
DIAGNOSIS: The stomach computed tomography scan revealed dilation of the proximal pancreatic duct with an irregular high-density calcification shadow situated on the head of the pancreas.
INTERVENTIONS: A pancreatic stent was positioned initially by ERCP to alleviate epigastric ache and alleviate symptom. Repeated ERCP was subsequently carried out 2 months later to extract the impacted massive pancreatic stone.
OUTCOME: By utilizing greedy forceps, the massive coralloid stone (272?×?zero?mm) was efficiently extracted in an en bloc method. Then, a 7-French?×?5?cm plastic pancreatic stent was positioned for two weeks. The affected person was freed from any pancreatic ache throughout the 2-year follow-up.
LESSONS: Usually, for giant or impacted pancreatic stones, endoscopic removing is technically tough to attain. Pancreatic stenting could be an efficient methodology of assuaging stomach ache and facilitating subsequent endoscopic lithoextraction. Extraction of enormous stones with greedy forceps could be another strategy as a substitute of extracorporeal shock wave lithotripsy or surgical procedure when stones are impacted on the papilla’s orifice and partially protruding into the duodenal lumen.
PMID: 29620654 [PubMed – indexed for MEDLINE]