Abstract
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) and/or extracorporeal shock
wave lithotripsy are first-line therapies for draining an obstructed pancreatic duct
(PD) in painful chronic calcifying pancreatitis (CCP). Pancreaticoscopy has shown
promising success rates in small series.
Materials and methods This study was a retrospective analysis of a clinical database. Included were all
digital single-operator digital video (SOV) pancreaticoscopy-guided interventions
(n = 23) on CCP patients (n = 20) between 2015 and 2017. Success and complication
rates were collected from the database. Clinical success was determined by assessing
pain level score (NRS) and quality of life (QoL) using standardized questionnaires.
Results Overall technical success rate (successful SOV-pancreaticoscopy and PD drainage)
was 95 %. Adverse events occurred in 7 of 23 procedures (30 %) and included extravasation
from the PD (n = 1), self-limiting post-sphincterotomy bleeding (n = 1) and post-ERCP
pancreatitis (PEP) (n = 6). At 3- to 6-month follow-up, 95 % of patients reported
improvement in symptoms and reduction in intake of analgesics. Mean NRS decreased
from 5.4 (±1.6) to 2.8 (± 1.8) (P < 0.01). Clinical success was achieved in 95 % of patients.
Conclusions Digital SOV-guided lithotripsy was found to be safe and effective in this highly
selected population of CCP patients. PD decompression had a beneficial effect on pain
reduction and QoL.
