Related Experiment Video
Updated: Jun 27, 2026
Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy
Published on: March 17, 2026
A minimally invasive alternative for managing large pancreatic duct stones using a modified expandable metal mesh
Xiu-Jiang Yang1, Yong Lin, Xin Zeng
1Department of Gastroenterology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
Background And Aim:
Endoscopic clearance of large or impacted stones in the main pancreatic duct (MPD) remains a clinical challenge. In this study, we attempted to technically modify the metallic stent to facilitate the clearance of large pancreatic stones in 4 patients, hoping to lower the operative risks and shorten hospital stay.
Patients And Methods:
Four patients with chronic pancreatitis and large stones in the MPD received endoscopic treatment. Inclusion criteria were: (1) pancreatic intraductal stones (number >3; diameter >or=10 mm) and strictures identified in the distal MPD; (2) calculi mainly located in the head, neck and/or body of the pancreas, and (3) failed clearance of stones using a balloon catheter or Dormia basket. Before clearing the pancreatic calculi completely, a technically modified uncovered self-expandable metallic pancreatic stent was implanted in the MPD for 4-7 days to dilate the ductal stenosis, and then drawn out through the working channel.
Results:
As the MPD had been sufficiently expanded by the stent, the calculi were removed completely and uneventfully by the balloon or Dormia basket in all 4 patients, without inducing major postoperative complications. A 9- to 15-month follow-up did not find major complications or recurrence of large calculi in the MPD.
Conclusions:
Technically modified metallic stenting is a minimally invasive and clinically feasible alternative to extracorporeal shock wave lithotripsy in the management of large pancreatic duct stones.
