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Gastrointest Endosc. 2013 Dec;78(6):925-9. doi: 10.1016/j.gie.2013.07.041. Epub 2013 Sep 17.

A novel basket catheter to facilitate endoscopic removal of pancreatic stones (with video).

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  • 1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Abstract

BACKGROUND:

Endoscopic removal of pancreatic stones in patients with chronic pancreatitis is still challenging. With a conventional basket catheter, introduction to the target area or catching pancreatic stones is sometimes difficult.

OBJECTIVE:

To evaluate a novel double-lumen basket catheter composed of nitinol wires with fine reticular structures in the distal end and loose mesh in the proximal part.

DESIGN:

A prospective feasibility study.

SETTING:

Tertiary-care center.

PATIENTS:

This study involved 10 patients with main pancreatic duct stones of 5 mm or less in the shorter diameter of the largest stone.

INTERVENTION:

In the first 5 cases, a nitinol basket catheter was used as salvage after stone extraction with a conventional basket catheter and retrieval balloon (salvage group). In the following 5 cases, stones were initially removed by using a nitinol basket catheter, and the presence of residual stones was evaluated by pancreatogram along with balloon sweep (initial group).

MAIN OUTCOME MEASUREMENTS:

Success rate of removal of the target stones and procedure-related adverse events.

RESULTS:

A nitinol basket catheter was easily introduced to the target stone in all patients. In the salvage group, additional stones were retrieved with a nitinol basket catheter in 3 of 5 patients. In the initial group, stone extraction by a nitinol basket catheter was successful, and no residual stones were extracted by additional balloon cleaning in any patients. Basket impaction or after-ERCP pancreatitis was not observed.

LIMITATIONS:

A small sample size without a control group.

CONCLUSION:

This novel nitinol basket catheter is useful for the extraction of small pancreatic stones. A randomized, controlled trial is warranted to confirm its efficacy.

Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

KEYWORDS:

ESWL; MPD; extracorporeal shockwave lithotripsy; main pancreatic duct

PMID:
24050311
[PubMed - indexed for MEDLINE]
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