Endoscopy 2019; 51(04): S139
DOI: 10.1055/s-0039-1681579
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 13:00 – 13:30: ERCP pancreas 1 ePoster Podium 4
Georg Thieme Verlag KG Stuttgart · New York

SPYGLASSDS GUIDED LITHOTRIPSY FOR PANCREATIC DUCT STONES IN SYMPTOMATIC, TREATMENT REFRACTORY CHRONIC PANCREATITIS – 12 MONTHS FOLLOW UP ON CLINICAL, TECHNICAL SUCCESS AND QUALITY OF LIFE

C Gerges
1   Innere Medizin, EVK Duesseldorf, Duesseldorf, Germany
,
D Pullmann
1   Innere Medizin, EVK Duesseldorf, Duesseldorf, Germany
,
M Schneider
1   Innere Medizin, EVK Duesseldorf, Duesseldorf, Germany
,
PD Siersema
2   Gastroenteroloy, Radboud University Medical Center, Nijmegen, Netherlands
,
H Neuhaus
1   Innere Medizin, EVK Duesseldorf, Duesseldorf, Germany
,
EJM van Geenen
2   Gastroenteroloy, Radboud University Medical Center, Nijmegen, Netherlands
,
T Beyna
1   Innere Medizin, EVK Duesseldorf, Duesseldorf, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Pancreatic duct (PD) stones are a common complication in chronic calcifying pancreatitis (CCP) and can contribute to pain onset and exacerbation. Digital-single-operator-pancreaticoscopy (d-SOP) guided lithotripsy was shown to be a promising option of therapy regarding technical success (95% ductal clearance) and clinical success after3 – 6 months FU (achieved in 95%) 1. There is only little evidence of mid-and long-term technical and clinical success or impact on quality of life2.

Methods:

Multicenter, retrospective analysis of all d-SOP (SpyGlass DS) guided lithotripsies (n = 23) of PD stones performed between 2015 and 2017 in 20 CCP patients. Clinical success (defined as pain reduction > 50% in numerical rating scale) was determined by a systematic questionnaire regarding pain intensity and incidence as well as quality of life based on SF-12 after 3, 6 and 12 months in an ongoing follow up.

Results:

After 12 months 2 of 20 patients were referred for partial pancreatectomy, one was lost to follow-up. Of the 17 remaining clinical success was persistent in 11 (55%). Regarding quality of life twelve patients described major improvements in symptoms and disability in daily life. There was no need of further interventional therapy except subsequent stenting in case of persistent PD strictures.

Conclusions:

D-SOP guided lithotripsy is safe and effective regarding technical success and clinical outcome. Beneficial effects on symptom control and quality of life seem to last in the majority of CCP patients after a 12 months follow-up and are comparable to published ESWL results. Technical success was persistent even after 12 months.

1. Gerges C PD, Bahin F et al. SpyGlassDS guided lithotripsy for pancreatic duct stones in symptomatic treatment refractory chronic calcifying pancreatitis. Endoscopy International Open 2018.

2. Gerges C, Pullmann D, Schneider M, et al. Pancreatoscopy in endoscopic treatment of pancreatic duct stones, systematic review. Minerva Chir 2018.