Endoscopy 2022; 54(S 01): S215
DOI: 10.1055/s-0042-1745167
Abstracts | ESGE Days 2022
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SINGLE-OPERATOR VIDEO PANCREATOSCOPY (SOVP) FOR THE MANAGEMENT OF SYMPTOMATIC PANCREATIC DUCT STONES IN SELECTED CHRONIC PANCREATITIS PATIENTS. A PROSPECTIVE MULTICENTRE COHORT TRIAL

L. Schmitz
1   Evangelisches Krankenhaus, Düsseldorf, Germany
,
A. Cappello
2   AUSL Bologna Maggiore Hospital, Bologna, Italy
,
D. Albers
3   Elisabeth Krankenhaus, Essen, Germany
,
M. Rousseau
4   Boston Scientific Corporation, Marlborough Massachusetts, United States
,
J. Schirra
5   Ludwig-Maximilians-Universität, München, Germany
,
E. Goni
5   Ludwig-Maximilians-Universität, München, Germany
,
J. Mayerle
5   Ludwig-Maximilians-Universität, München, Germany
,
M. Casper
6   Universitätsklinikum des Saarlandes, Homburg, Germany
,
T. Weismüller
7   Humboldt Klinikum, Berlin, Germany
,
A. Dormann
8   Kliniken Köln Mehrheim, Koeln, Germany
,
D. Hartmann
9   Marienhausklinikum Mainz, Mainz, Germany
,
M. Hollenbach
10   Universitaetsklinikum Leipzig, Leipzig, Germany
,
J. Hampe
11   Universitaetsklinikum Dresden, Dresden, Germany
,
A. Kandulski
12   Universitaetsklinikum Regensburg, Regensburg, Germany
,
A. Hoffman
13   Klinkum Aschaffenburg-Alzenau, Aschaffenburg, Germany
,
U. Denzer
14   Universitätskliikum Marburg, Marburg, Germany
,
A. Dechene
15   Klinikum Nürnberg, Nürnberg, Germany
,
A. Arlt
16   Uniklinik Oldenburg, Oldenburg, Germany
,
C. Schlag
17   University Hospital Zurich, Zurich, Switzerland
,
M. Dollhopf
18   München Klinik, München, Germany
,
B. Schumacher
3   Elisabeth Krankenhaus, Essen, Germany
,
E. van Geenen
19   Radboud University Nijmegen, Nijmegen, Netherlands
,
P. Siersema
19   Radboud University Nijmegen, Nijmegen, Netherlands
,
H. Neuhaus
1   Evangelisches Krankenhaus, Düsseldorf, Germany
,
M. Ellrichmann
20   Universitaetsklinikum Kiel, Kiel, Germany
,
T. Beyna
1   Evangelisches Krankenhaus, Düsseldorf, Germany
,
C. Gerges
1   Evangelisches Krankenhaus, Düsseldorf, Germany
› Author Affiliations
 
 

    Aims SOVP-guided treatment of pancreatolithiasis offers an alternative to extracorporeal shock wave lithotripsy(ESWL) in patients with symptomatic chronic obstructive pancreatitis(SCOP). We present early results of a prospective evaluation of the efficacy, safety and clinical outcome of SOVP-guided lithotripsy.

    Methods Between 2019-2021 patients with SCOP were enrolled in a prospective multicenter cohort study. The sample size calculation was based on the hypothesis of SOVP higher technical success over ESWL(Performance Goal of 74%). Primary endpoint was technical success defined as complete PD clearance within three SOVP sessions. Secondary endpoints included: clinical success, assessed by Izbicki pain score(IPS) improvement from baseline with complete/partial pain relief evaluation over time; incidence of adverse events(AE) reported in the follow-up; radiological PD diameter assessment before and 6 months after final SOVP.

    Results We enrolled 40 patients with 1.7(±1.3)pancreatic stones, 8.4mm(±2.9)upstream PD diameter, and 55.3(±46.2)baseline IPS. SOVP achieved a complete stone clearance rate of 90.0%(36/40;p=0.011) with mean number of 1.33(STD0.62)SOVP-sessions. Pancreatic stents were placed in 88.7%(47/53) of the procedures for post-ERCP pancreatitis prophylaxis or treatment of associated strictures. Mild AE were registered in 7.5%(3/40)of the cases. At 6 months follow-up, the rate of residual stones was 0.0%(0/33), PD diameter decreased to 4.8mm±2.0 and IPS was 9.0±16.7 with complete pain relief/partial pain relief in the 66.7%(22/33)/21.2%(7/33).

    Table 1

    Izbicki Pain Score

    Change in Izbicki Pain Score From Baseline

    Baseline

    55.3±46.2(40)(0.0,303.8)(33.5,49.5,63.8)

    NA

    Final 30 Day Visit

    23.6±23.8(23)(0.0,63.8)(0.0,20.8,48.3)

    -30.9±24.5(23)(-76.7,0.0)(-50.5, -23.3,-11.3)

    Final 3 Month Visit

    17.3±22.9(34)(0.0,76.3)(0.0,0.0,25.8)

    -42.9±47.3(34)(-272.1,6.3)(-50.0,-44.6,-17.5)

    6 Month Visit

    9.0±16.7(33)(0.0,76.3)(0.0,0.0,13.8)

    -48.3±48.5(33)(-280.4,6.3)(-50.0,-45.5,-23.3)

    Zoom Image
    Fig. 1

    Conclusions SOVP-guided treatment of symptomatic PD stones is safe and achieves ductal clearance in 90% selected SCOP patients. Median-term results show pain relief in more than 2/3 cases. SOVP-guided lithotripsy is an effective alternative for ESWL for PD stones.


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    Publication History

    Article published online:
    14 April 2022

    © 2022. European Society of Gastrointestinal Endoscopy. All rights reserved.

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    Zoom Image
    Fig. 1