CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(12): E1229-E1234
DOI: 10.1055/s-0043-119752
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Endoscopic pancreatic balloon sphincteroplasty for difficult to treat pancreatic stones and strictures: experience in 80 patients

Rinkesh Kumar Bansal
Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, India
,
Gaurav Kumar Patil
Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, India
,
Rajesh Puri
Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, India
,
Narendra S. Choudhary
Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, India
,
Saurabh R. Patle
Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, India
,
Zubin D. Sharma
Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, India
,
Randhir Sud
Institute of Digestive and Hepatobiliary Sciences, Medanta – The Medicity, Gurugram, Haryana, India
› Author Affiliations
Further Information

Publication History

submitted 14 March 2017

accepted after revision 24 July 2017

Publication Date:
06 December 2017 (online)

Abstract

Background and aim There is paucity of data about endoscopic pancreatic sphincteroplasty (EPS) after endoscopic pancreatic sphincterotomy (EPST) in the treatment of chronic pancreatitis. The aim of this study was to establish the indications for EPS, complications related to it, and to examine its effectiveness in managing chronic pancreatitis after a year of follow-up.

Methods We evaluated the safety and efficacy of pancreatic balloon dilation coupled with sphincterotomy for the treatment of chronic pancreatitis. The technical success rate of balloon dilation, stone clearance, frequency of pancreatic stenting, and procedure-related adverse events were recorded.

Results Out of 580 patients who underwent pancreatic endotherapy between July 2014 and February 2016, 80 patients underwent EPS. The mean age of these 80 patients was 34 ± 11 years, and 80 % (n = 64) were males. The common indications were removal of large radiolucent stones in 31 patients; unyielding radiopaque stones post extracorporeal shock wave lithotripsy (ESWL) in 20 patients, and pancreatic duct stricture combined with stones in 29 patients. EPS could be successfully completed in 98.75 % of patients. Complete ductal clearance in a single session was achieved in only 25 patients, while 26 patients required two sessions. There were two adverse events of pain requiring admission for more than 24 hours and one procedure related bleeding, all of which were managed conservatively. The patients had an average follow-up of 8 months (6 – 12 months) and all the patients were pain free.

Conclusions Endoscopic pancreatic sphincteroplasty is a relatively safe procedure with a low incidence of complications and a high rate of treatment success.