Endoscopic approach to pancreatic duct calculi and obstructive pancreatitis

Twelve patients with chronic pancreatitis and obstructing pancreatic calculi underwent endoscopic retrograde cholangiopancreatography and attempted pancreatic stone extraction. This procedure, utilizing conventional stone baskets and balloons, as well as extracorporeal or laser lithotripsy in a subset, was ultimately successful in 11 of 12 patients. Nine of the 10 patients with relapsing pancreatitis have not had a symptomatic flare at a mean follow-up of 17 months. In contrast, neither of the patients who presented with chronic pain had convincing symptomatic improvement. The authors conclude that endoscopic removal of pancreatic duct calculi deserves further investigation in the treatment of relapsing attacks of chronic pancreatitis.