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1 "Biswaranjan Patra"
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Original Article
Outcomes of Dilation of Recalcitrant Pancreatic Strictures Using a Wire-Guided Cystotome
Sridhar Sundaram, Dhaval Choksi, Aditya Kale, Suprabhat Giri, Biswaranjan Patra, Shobna Bhatia, Akash Shukla
Clin Endosc 2021;54(6):903-908.   Published online March 4, 2021
DOI: https://doi.org/10.5946/ce.2020.297
AbstractAbstract PDFPubReaderePub
Background
/Aims: Pancreatic strictures in chronic pancreatitis are treated using endoscopic retrograde cholangiopancreatography (ERCP) with plastic stent placement. The management of recalcitrant strictures remains a challenge, with the use of a Soehendra stent retriever or a needle knife described in case reports. Here, we discuss our experience with dilation of dominant pancreatic strictures with a 6-Fr cystotome.
Methods
A retrospective review of an endoscopy database was performed to search for patients with pancreatic strictures recalcitrant to conventional methods of dilation in which a cystotome was used. Technical success was defined as the successful dilation of the stricture with plastic stent placement. Functional success was defined as substantial pain relief or resolution of pancreatic fistulae.
Results
Ten patients (mean age, 30.8 years) underwent dilation of a dominant pancreatic stricture secondary to chronic pancreatitis, with a 6-Fr cystotome. Seven patients presented with pain. Three patients had pancreatic fistulae (two had pancreatic ascites and one had a pancreaticopleural fistula). The median stricture length was 10 mm (range, 5–25 mm). The head of the pancreas was the most common location of the stricture (60%). Technical and functional success was achieved in all patients. One patient had self-limiting bleeding, whereas another patient developed mild post-ERCP pancreatitis.
Conclusions
The use of a 6-Fr cystotome (diathermy catheter) can be an alternative method for dilation of recalcitrant pancreatic strictures after the failure of conventional modalities.

Citations

Citations to this article as recorded by  
  • Fully Covered Self-expandable Metallic Stents for Refractory Benign Pancreatic Duct Strictures: A Systematic Review and Meta-analysis
    Gajanan Rodge, Suprabhat Giri, Kailash Kolhe, Shivaraj Afzalpurkar, Sidharth Harindranath, Sridhar Sundaram, Aditya Kale
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(5): 529.     CrossRef
  • Treatment of Difficult Pancreatic Duct Strictures Using a Cystotome: A Single-Center Experience
    Jonghyun Lee, Dong Uk Kim, Sung Yong Han
    The Korean Journal of Pancreas and Biliary Tract.2023; 28(4): 108.     CrossRef
  • Approach to management of pancreatic strictures: the gastroenterologist’s perspective
    Vaneet Jearth, Suprabhat Giri, Sridhar Sundaram
    Clinical Journal of Gastroenterology.2021; 14(6): 1587.     CrossRef
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