Pancreatoscopy-Directed Electrohydraulic Lithotripsy for Pancreatic Ductal Stones in Painful Chronic Pancreatitis Using SpyGlass

Bekkali, Noor; Murray, Sam; Johnson, Gavin; Bandula, Steven; Amin, Zahir; Chapman, Michael H.; Pereira, Stephen P.; Webster, George

doi:10.1097/mpa.0000000000000790

Cited by 51 publications

(29 citation statements)

References 15 publications

(18 reference statements)

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“…Due to the small cohort, no definite answer can be provided as to whether laser lithotripsy or EHL is more effective. However, it is in line with reported PEP rates in average high-risk ERCP patients of 20.2 % to 40 % [14 -15] and in SOVP patients with PEP up to 28 % [2,4,6]. Risk factors include patient-, physician-or procedure-related and are additive [14].…”

Section: Discussionsupporting

confidence: 87%

Untitled

2019

Endosc Int Open

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Endoscopic management for pain from chronic calcifying pancreatitis (CCP) can be achieved by draining an obstructed pancreatic duct (PD) and/or removing obstructing PD calculi [1]. Current guidelines recommend extracorporeal shock wave lithotripsy (ESWL) as first-line treatment of PD stones. However, its limitations include lack of availability and the need for multiple ESLW and endoscopic retrograde cholangiopancreatography (ERCP) sessions [2]. The role of pancreatoscopy in PD stone treatment is unclear, with reported success rates between 43 % and 100 %, based on small retrospective studies [2-7]. In 2015, single-operator digital video cholangiopancreaticoscopy (SOVP) (SpyGlassDS, Boston-Scientific) was introduced. There is limited data on the role of SOVP in the treatment of PD stones in CP. Our aim was to investigate the role of digital SOVP-guided PD stone lithotripsy in patients with CP with regard to safety, technical and short-term clinical success.

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Section: Discussionsupporting

confidence: 87%

Untitled

2019

Endosc Int Open

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“…A technical success rate of 94% was achieved using the legacy and DS version of the SpyGlass™ device in this study. However, the diagnosis obtained via SOCP in our study was subject to error, which is consistent with previously published findings (6,14,47). While there are no validated criteria available that enable the differentiation between malignant and benign endoscopic lesions in vivo, we used criteria defined in previous studies to perform an endoscopic diagnosis (6,27,35,36).…”

Section: A B C Dsupporting

confidence: 85%

Single-operator cholangiopancreatoscopy in pancreatobiliary diseases: clinical experience in a tertiary referral hospital

Beltrán¹,

Alonso-Lázaro²,

Mansilla-Vivar³

et al. 2018

Rev Esp Enferm Dig

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“…Of these, 10 relevant publications meeting the inclusion criteria were identified. There were only two prospective series, six retrospective trials and two case reports including 87 patients altogether (Table ) . Only one trial consisted of more than 10 patients, prospective randomized controlled trials lacked completely.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic treatment of pancreatic duct stones under direct vision: Revolution or resignation? Systematic review

Beyna

Neuhaus

Gerges

2017

Digestive Endoscopy

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Background and Aim: The main treatment aim in chronic pancreatitis (CP) is symptom control and especially pain relief. Management of stone-predominant CP is challenging and requires a multidisciplinary approach. Extracorporeal shock wave lithotripsy (ESWL) has emerged as the cornerstone of nonsurgical treatment as a result of disappointing results of available endoscopic treatment options during the last decades. With new developments in the field of direct peroral pancreatoscopy (POP) and intracorporeal lithotripsy, direct intraluminal treatment of main pancreatic duct (MPD) stones returns to the spotlight.Methods: Herein, we reviewed the current data on direct pancreatoscopic treatment of MPD stones with a focus on efficiency and safety of available technologies, endoscopes and lithotripsy devices. A systematic Medline search for relevant studies was done.Results: Ten relevant publications meeting the inclusion criteria were identified (two prospective series, six retrospective trials, two case reports, n = 87 patients). Successful ductal clearance for POP-guided treatment was reported as between 43% and 100% compared to ESWL with 59% to 80%. Adverse event rate for POP-guided therapy was reported as 0-13.5%. One study showed a noticeable higher adverse event rate of 43%. In this trial, POP was carried out after ESWL. There is no reported mortality following POP treatment. Conclusion:Available results are promising in terms of ductal clearance and pain relief compared to standard endoscopic techniques and ESWL as the current gold standard for lithotripsy. Interpretation of this data is limited by the small number of cases for POP and the lack of prospective randomized controlled trials.

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Pancreatoscopy-Directed Electrohydraulic Lithotripsy for Pancreatic Ductal Stones in Painful Chronic Pancreatitis Using SpyGlass

Cited by 51 publications

References 15 publications

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Single-operator cholangiopancreatoscopy in pancreatobiliary diseases: clinical experience in a tertiary referral hospital

Endoscopic treatment of pancreatic duct stones under direct vision: Revolution or resignation? Systematic review

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