Sa1498 Pancreatoscopy-Guided Laser Lithotripsy for Difficult Pancreatic Duct Stones. A Single Center Experience

Malachias, Apostolos; Kypraios, Dimitrios; Theodoropoulos, Loukas; Hatzinicolaou, Stamatia-Lydia; Stavrinides, Stavros; Saribegioglou, Nikolaos; Dimitroulopoulos, Dimitrios; Tsamakidis, Klisthenis; Korkolis, Dimitrios; Xinopoulos, Dimitrios

doi:10.1016/j.gie.2016.03.414

Cited by 2 publications

(3 citation statements)

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“…The result of the initial search yielded a total of 2112 articles, of which 15 original articles published from 1999 to 2019 were included in the final analysis 4,6,10‐12,18‐27 . Four abstracts 28–31 (two prospective, and two retrospective) were identified during the literature search, but were not considered in the final analysis because they did not present complete data. In all, 11 studies were retrospective and four were prospective.…”

Section: Resultsmentioning

confidence: 99%

Per‐oral pancreatoscopy‐guided lithotripsy for the endoscopic management of pancreatolithiasis: A systematic review and meta‐analysis

Guzmán-Calderón

Martínez‐Moreno

Casellas

et al. 2021

J of Digest Diseases

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Objective Pancreatic stones result from chronic pancreatitis and can occur in the main pancreatic duct, pancreatic branches or parenchyma. Although extracorporeal shock wave lithotripsy (ESWL) is considered the first‐line treatment, per‐oral pancreatoscopy (POP) has emerged as a useful method for treating pancreatic stones. The aim of this systematic review and meta‐analysis was to determine the efficacy and safety of POP‐guided lithotripsy, electrohydraulic lithotripsy (EHL) and laser lithotripsy (LL), in patients with pancreatolithiasis. Methods Literature review was conducted in PubMed, OVID, MEDLINE and Cochrane Library databases for studies published up to August 2020. Results Altogether 15 studies were analyzed, of which 11 were retrospective and four were prospective. The studies comprised 370 patients, of whom 66.4% were male. The patients underwent 218 EHL and 155 LL. The pooled technical and clinical success rate of the overall POP was 88.1% and 87.1%. For EHL‐POP, the pooled technical success rate was 90.9% (95% CI 87.2%‐95.2%) and the pooled clinical success rate was 89.8% (95% CI 87.2%‐95.2%). While for LL‐POP, the pooled technical and clinical success rate was 88.4% (95% CI 85.9%‐95.1%) and 85.8% (95% CI 80.6%‐91.6%). In total 43 adverse events occurred (12.1%; 95% CI 8.7%‐15.5%). Conclusion POP‐guided lithotripsy has a high rate of technical and clinical success for managing pancreatolithiasis with a low complication rate. Both EHL‐POP and LL‐POP achieve similar efficacy in the endoscopic therapy of pancreatolithiasis. Further large randomized controlled trials are needed to compare EHL‐POP and LL‐POP with ESWL and evaluate whether POP may replace ESWL as the first‐line management of pancreatolithiasis.

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Section: Resultsmentioning

confidence: 99%

Per‐oral pancreatoscopy‐guided lithotripsy for the endoscopic management of pancreatolithiasis: A systematic review and meta‐analysis

Guzmán-Calderón

Martínez‐Moreno

Casellas

et al. 2021

J of Digest Diseases

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“…There was a total of 16 studies that reported on POP lithotripsy procedures. Ten of these studies reported outcomes on POP using EHL[ 2 , 7 - 9 , 20 , 21 , 23 , 25 , 29 , 30 ] and 8 studies reported outcomes on POP using LL[ 2 , 20 , 21 , 24 , 26 - 28 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…Multiple stones, strictures, impacted stones, difficulty in cannulating PD due to angulation, poor visibility, equipment failure, or stones greater than 17 mm are other factors that may lead to lower technical success of POP[ 2 , 7 , 9 , 22 - 24 , 28 - 30 ]. Gutierrez et al[ 2 ] reported that presence of 3 or more stones was an independent risk factor for technical failure of POP ( P < 0.04).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of pancreatoscopy for pancreatic duct stones: A systematic review and meta-analysis

Saghir

Mashiana

Mohan

et al. 2020

WJG

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BACKGROUND Pancreatic duct stones can lead to significant abdominal pain for patients. Per oral pancreatoscopy (POP)-guided intracorporal lithotripsy is being increasingly used for the management of main pancreatic duct calculi (PDC) in chronic pancreatitis. POP uses two techniques: Electrohydraulic lithotripsy (EHL) and laser lithotripsy (LL). Data on the safety and efficacy are limited for this procedure. We performed a systematic review and meta-analysis with a primary aim to calculate the pooled technical and clinical success rates of POP. The secondary aim was to assess pooled rates of technical success, clinical success for the two individual techniques, and adverse event rates. AIM To perform a systematic review and meta-analysis of POP, EHL and LL for management of PDC in chronic pancreatitis. METHODS We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, EMBASE, Cochrane, Google Scholar and Web of Science databases (from 1999 to October 2019) to identify studies with patient age greater than 17 and any gender that reported on outcomes of POP, EHL and LL. The primary outcome assessed involved the pooled technical success and clinical success rate of POP. The secondary outcome included the pooled technical success and clinical success rate for EHL and LL. We also assessed the pooled rate of adverse events for POP, EHL and LL including a subgroup analysis for the rate of adverse event subtypes for POP: Hemorrhage, post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP), perforation, abdominal pain, fever and infections. Technical success was defined as the rate of clearing pancreatic duct stones and clinical success as the improvement in pain. Random-effects model was used for analysis. Heterogeneity between study-specific estimates was calculated using the Cochran Q statistical test and I 2 statistics. Publication bias was ascertained, qualitatively by visual inspection of funnel plot and quantitatively by the Egger test. RESULTS A total of 16 studies including 383 patients met the inclusion criteria. The technical success rate of POP was 76.4% (95%CI: 65.9-84.5; I 2 = 64%) and clinical success rate was 76.8% (95%CI: 65.2-85.4; I 2 = 66%). The technical success rate of EHL was 70.3% (95%CI: 57.8-80.3; I 2 = 36%) and clinical success rate of EHL was 66.5% (95%CI: 55.2-76.2; I 2 = 19%). The technical success rate of LL was 89.3% (95%CI: 70.5-96.7; I 2 = 70%) and clinical success rate of LL was 88.2% (95%CI: 66.4-96.6; I 2 = 77%). The incidence of pooled adverse events for POP was 14.9% (95%CI: 9.2-23.2; ...

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Sa1498 Pancreatoscopy-Guided Laser Lithotripsy for Difficult Pancreatic Duct Stones. A Single Center Experience

Cited by 2 publications

References 0 publications

Per‐oral pancreatoscopy‐guided lithotripsy for the endoscopic management of pancreatolithiasis: A systematic review and meta‐analysis

Per‐oral pancreatoscopy‐guided lithotripsy for the endoscopic management of pancreatolithiasis: A systematic review and meta‐analysis

Efficacy of pancreatoscopy for pancreatic duct stones: A systematic review and meta-analysis

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