Enhanced endoscopic clearance of pancreatic duct stones using a novel rotating basket catheter: a comparative study

Pancreatic duct stones in chronic pancreatitis contribute to ductal hypertension, pain, and progressive pancreatic dysfunction. While extracorporeal shock wave lithotripsy (ESWL) and pancreatoscopy-guided lithotripsy facilitate stone fragmentation, clearing residual fragments remains challenging. We evaluated the efficacy and safety of a novel rotating basket catheter (RASEN) for endoscopic retrieval of small or fragmented stones.

We retrospectively analyzed 63 patients who underwent endoscopic treatment for pancreatic duct stones between 2018 and 2025 at Nagoya City University Hospital. Patients were categorized into a conventional group (standard basket or balloon catheter, n = 32) and a novel group (RASEN catheter, n = 31). The primary outcome was complete stone clearance; secondary outcomes included adverse events and device-specific stone capture rates.

In total, 74 procedures were evaluated (conventional: 39; novel: 35). The complete clearance rate was significantly higher in the novel group compared to the conventional group (82.9% vs. 53.8%, P = 0.012). Multivariable analysis identified RASEN use as the only independent predictor of complete clearance (P = 0.007). Device-specific analysis exhibited that RASEN achieved a higher complete clearance rate (82.9%) than all conventional baskets (33.3-50.0%) and retrieval balloons (8.1%). No significant differences in adverse events were observed between groups.

The RASEN catheter significantly improved complete stone clearance without increasing procedural risk. Its structural design appears to facilitate retrieval of small or fragmented stones in anatomically complex ducts. These findings suggest RASEN is a promising tool in the endoscopic management of pancreatic duct stones.