Korean J Med.  2017 Dec;92(6):533-536. 10.3904/kjm.2017.92.6.533.

Removal of Pancreatic Duct Stones by Endoscopic Ultrasonography-Guided Rendezvous ERCP

• Hsing LC
• Kim J
• Kim HI
• Park JC
• Han J
• Jun JH
• Kim MH

• KMID: 2400918
• DOI: http://doi.org/10.3904/kjm.2017.92.6.533

Abstract

Symptomatic pancreatic ductal stones can be removed nonsurgically by endoscopic retrograde cholangiopancreatography (ERCP), either alone or in combination with extracorporeal shock-wave lithotripsy (ESWL). Here, we report a case of successful endoscopic ultrasonography (EUS)-guided rendezvous ERCP for removal of radiolucent pancreatic stones after failed ERCP and ESWL. A 79-year-old male with painful chronic pancreatitis associated with pancreatic stones and a dilated upstream duct underwent transgastric antegrade pancreatography via EUS-guided pancreatic duct access followed by rendezvous ERCP. In this patient, EUS-guided rendezvous ERCP was successful in salvaging pancreatic duct cannulation after unsuccessful ERCP due to a tight stricture at the pancreatic duct orifice and removing radiolucent pancreatic stones after ESWL, which was unsuccessful because of failure to localize the stones due to their radiolucency under x-ray fluoroscopy.

Keyword

Chronic pancreatitis; Lithotripsy; Cholangiopancreatography; Endoscopic retrograde

MeSH Terms

Aged
Catheterization
Cholangiopancreatography, Endoscopic Retrograde*
Constriction, Pathologic
Endosonography
Fluoroscopy
Humans
Lithotripsy
Male
Pancreatic Ducts*
Pancreatitis, Chronic