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Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome
BACKGROUND/AIMS: Pancreatic strictures in chronic pancreatitis are treated using endoscopic retrograde cholangiopancreatography (ERCP) with plastic stent placement. The management of recalcitrant strictures remains a challenge, with the use of a Soehendra stent retriever or a needle knife described...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Gastrointestinal Endoscopy
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652154/ https://www.ncbi.nlm.nih.gov/pubmed/33657781 http://dx.doi.org/10.5946/ce.2020.297 |
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author | Sundaram, Sridhar Choksi, Dhaval Kale, Aditya Giri, Suprabhat Patra, Biswaranjan Bhatia, Shobna Shukla, Akash |
author_facet | Sundaram, Sridhar Choksi, Dhaval Kale, Aditya Giri, Suprabhat Patra, Biswaranjan Bhatia, Shobna Shukla, Akash |
author_sort | Sundaram, Sridhar |
collection | PubMed |
description | BACKGROUND/AIMS: Pancreatic strictures in chronic pancreatitis are treated using endoscopic retrograde cholangiopancreatography (ERCP) with plastic stent placement. The management of recalcitrant strictures remains a challenge, with the use of a Soehendra stent retriever or a needle knife described in case reports. Here, we discuss our experience with dilation of dominant pancreatic strictures with a 6-Fr cystotome. METHODS: A retrospective review of an endoscopy database was performed to search for patients with pancreatic strictures recalcitrant to conventional methods of dilation in which a cystotome was used. Technical success was defined as the successful dilation of the stricture with plastic stent placement. Functional success was defined as substantial pain relief or resolution of pancreatic fistulae. RESULTS: Ten patients (mean age, 30.8 years) underwent dilation of a dominant pancreatic stricture secondary to chronic pancreatitis, with a 6-Fr cystotome. Seven patients presented with pain. Three patients had pancreatic fistulae (two had pancreatic ascites and one had a pancreaticopleural fistula). The median stricture length was 10 mm (range, 5–25 mm). The head of the pancreas was the most common location of the stricture (60%). Technical and functional success was achieved in all patients. One patient had self-limiting bleeding, whereas another patient developed mild post-ERCP pancreatitis. CONCLUSIONS: The use of a 6-Fr cystotome (diathermy catheter) can be an alternative method for dilation of recalcitrant pancreatic strictures after the failure of conventional modalities. |
format | Online Article Text |
id | pubmed-8652154 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Korean Society of Gastrointestinal Endoscopy |
record_format | MEDLINE/PubMed |
spelling | pubmed-86521542021-12-20 Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome Sundaram, Sridhar Choksi, Dhaval Kale, Aditya Giri, Suprabhat Patra, Biswaranjan Bhatia, Shobna Shukla, Akash Clin Endosc Original Article BACKGROUND/AIMS: Pancreatic strictures in chronic pancreatitis are treated using endoscopic retrograde cholangiopancreatography (ERCP) with plastic stent placement. The management of recalcitrant strictures remains a challenge, with the use of a Soehendra stent retriever or a needle knife described in case reports. Here, we discuss our experience with dilation of dominant pancreatic strictures with a 6-Fr cystotome. METHODS: A retrospective review of an endoscopy database was performed to search for patients with pancreatic strictures recalcitrant to conventional methods of dilation in which a cystotome was used. Technical success was defined as the successful dilation of the stricture with plastic stent placement. Functional success was defined as substantial pain relief or resolution of pancreatic fistulae. RESULTS: Ten patients (mean age, 30.8 years) underwent dilation of a dominant pancreatic stricture secondary to chronic pancreatitis, with a 6-Fr cystotome. Seven patients presented with pain. Three patients had pancreatic fistulae (two had pancreatic ascites and one had a pancreaticopleural fistula). The median stricture length was 10 mm (range, 5–25 mm). The head of the pancreas was the most common location of the stricture (60%). Technical and functional success was achieved in all patients. One patient had self-limiting bleeding, whereas another patient developed mild post-ERCP pancreatitis. CONCLUSIONS: The use of a 6-Fr cystotome (diathermy catheter) can be an alternative method for dilation of recalcitrant pancreatic strictures after the failure of conventional modalities. Korean Society of Gastrointestinal Endoscopy 2021-11 2021-03-04 /pmc/articles/PMC8652154/ /pubmed/33657781 http://dx.doi.org/10.5946/ce.2020.297 Text en Copyright © 2021 Korean Society of Gastrointestinal Endoscopy https://creativecommons.org/licenses/by-nc/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Sundaram, Sridhar Choksi, Dhaval Kale, Aditya Giri, Suprabhat Patra, Biswaranjan Bhatia, Shobna Shukla, Akash Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome |
title | Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome |
title_full | Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome |
title_fullStr | Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome |
title_full_unstemmed | Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome |
title_short | Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome |
title_sort | outcomes of dilation of recalcitrant pancreatic strictures using a wire-guided cystotome |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652154/ https://www.ncbi.nlm.nih.gov/pubmed/33657781 http://dx.doi.org/10.5946/ce.2020.297 |
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