A novel technique for the treatment of impacted pancreatic stones after pancreatoduodenectomy using transanastomotic fluoroscopic-guided electrohydraulic lithotripsy

The “tapping-a-screw method” for endoscopic removal of an incarcerated pancreatic duct stone using a novel screw-shaped dilator with a 0.018-inch guidewire

“…Endoscopic intervention is an established treatment in patients with obstructive pancreatitis; however, dealing with impacted pancreatic duct stones remains challenging. Although electrohydraulic or laser lithotripsy under digital single-operator pancreatoscopy (D-SOP) is one of the feasible approaches 1 , some special techniques are required in cases where D-SOP is not applicable 2 3 . Herein, we report a method to accomplish endoscopic removal of an incarcerated pancreatic duct stone using a novel stiff screw-shaped dilator with a 0.018-inch guidewire.…”