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Advanced techniques for pancreaticobiliary stone extraction.

ABSTRACT:

Background and aims

Pancreaticobiliary stone extraction during endoscopic retrograde cholangiopancreatography can be challenging when working space is limited or the duct is irregular and strictured. We aimed to demonstrate several difficult anatomic scenarios in which stone extraction was accomplished by ductoscopic grasping and retrieval using miniature devices.

Methods

In 2 cases, a miniature retrieval basket and snare are used during cholangioscopy to grasp refractory stones in the intrahepatic and cystic ducts, respectively. In cases 3 and 4, a miniature basket and snare are used during pancreatoscopy to facilitate stone extraction from stenotic and tortuous pancreatic ducts. In case 5, a miniature forceps is used to extract a stone from within a dilated pancreatic side branch.

Results

Stone extraction was successful in all cases without adverse events.

Conclusions

Miniature grasping accessories that fit through the working channel of the cholangioscope/pancreatoscope may allow stone retrieval in difficult anatomic scenarios and thus represent a meaningful addition to our therapeutic armamentarium for the treatment of this condition.

SUBMITTER: Elmunzer BJ

PROVIDER: S-EPMC7332830 | biostudies-literature |

REPOSITORIES: biostudies-literature

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