Endoscopy 2019; 51(04): S147
DOI: 10.1055/s-0039-1681604
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 13:30 – 14:00: ERCP pancreas 2 ePoster Podium 4
Georg Thieme Verlag KG Stuttgart · New York

SINGLE-OPERATOR PANCREATOSCOPY (SOP) WITH SPYGLASS SYSTEM IN PATIENTS WITH CHRONIC PANCREATITIS

R Mansilla-Vivar
1   Digestive Endoscopy Unit, Health Research Institute Hospital La Fe, La Fe Polytechnic University Hospital, Valencia, Spain
2   Digestive Endoscopy Unit, Puerto Montt Hospital, Puerto Montt, Chile
,
L Argüello-Viudez
1   Digestive Endoscopy Unit, Health Research Institute Hospital La Fe, La Fe Polytechnic University Hospital, Valencia, Spain
,
C Sanchez-Montes
1   Digestive Endoscopy Unit, Health Research Institute Hospital La Fe, La Fe Polytechnic University Hospital, Valencia, Spain
,
N Alonso-Lazaro
1   Digestive Endoscopy Unit, Health Research Institute Hospital La Fe, La Fe Polytechnic University Hospital, Valencia, Spain
,
M Ponce-Romero
1   Digestive Endoscopy Unit, Health Research Institute Hospital La Fe, La Fe Polytechnic University Hospital, Valencia, Spain
,
M Bustamante-Balén
1   Digestive Endoscopy Unit, Health Research Institute Hospital La Fe, La Fe Polytechnic University Hospital, Valencia, Spain
,
V Pons-Beltrán
1   Digestive Endoscopy Unit, Health Research Institute Hospital La Fe, La Fe Polytechnic University Hospital, Valencia, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Interventional procedures for pain treatment in chronic pancreatitis include extracorporeal shock wave lithotripsy, endoscopic stone extraction and bridging of pancreatic strictures. Standard treatment is effective in 90% of cases. Direct pancreatoscopy using smaller-caliber endoscopic equipments have been developed to explore and treat in biliary and pancreatic duct with promissory results.

To assess the usefulness, efficacy and safety of single-operator-pancreatoscopy (SOP) with the SpyGlass system in symptomatic patients with chronic calcifying pancreatitis.

Methods:

Retrospective review of a prospectively-maintained database of endoscopic procedures in a tertiary referral center. Consecutive adults confirmed with symptomatic pancreatic lithiasis after standard treatment with ERCP underwent to SOP with SpyGlass between September 2008 and October 2018.

Results:

We performed 20 procedures in 11 patients. From 2008 to 2015, we use legacy SpyGlass and then we use SpyGlass DS. Seven patients (63%) were male with a median age of 56 years (± 11,3). Mean time procedure in ERCP was 92 minutes (± 38,6) with 23 minutes (± 13,2) of SOP with SpyGlass. Median time of follow up was 6 months (range 1 – 55). Technical success was achieved in 18/20 (90%) procedures and clinical success in 10/11 (90%) of patients. To achieve clinical success, 5 patients needed 1 procedure, 4 patients needed 2 procedures, 1 patient needed 3 procedures and 1 patient need 4 procedures. Mean number of pancreatic stones was 2 (range 1 to +5) with mean size of 7.5 mm (± 4,85). SpyGlass with intraductal laser lithotripsy was used in 3 procedures and electrohydraulic lithotripsy in 8 procedures. This clinical series has no mortality and 1 patient needed surgery. We report 2 minor technical complications resolved in the same procedure.

Conclusions:

SOP is a useful and safe technique for treating pancreatic lithiasis with low rate of adverse effects. However, this procedure must to be performed by expert endoscopists.