The central dogma of pain in patients with chronic pancreatitis revolves around the pathophysiology of ductal hypertension owing to stones that obstruct the pancreatic duct. Conventional modalities available to decompress the pancreatic duct are occasionally limited by failed selective pancreatic duct cannulation during endoscopic retrograde cholangiopancreatography. We describe a novel endoscopic approach of EUS-guided laser lithotripsy to assist in pancreatic duct (PD) stone fragmentation in two symptomatic patients with underlying chronic pancreatitis who had failed PD cannulation and extracorporeal shock wave lithotripsy (ESWL). In both cases, a 365-micrometer LightTrail TracTip Holmium laser fiber was advanced within a 19G endoscopic ultrasound aspiration needle (Expect Slimline (SL), Boston Scientific, Marlborough, Massachusetts, United States) under endoscopic ultrasound (EUS) guidance to fragment the PD stones. There were no procedure-related complications encountered and follow-up after 1 month of the procedure revealed significant reduction in abdominal pain scores. To the best of our knowledge, these are the first reported cases of EUS-guided laser lithotripsy performed for PD stones. Our approach of performing laser lithotripsy under EUS guidance obviates the need for an ESWL procedure; however, it is technically more challenging and requires precision to avoid injury to the pancreas. Further prospective studies are required to evaluate the safety and efficacy of this novel approach and its applicability as either a rescue procedure or in tandem with conventional pancreatic endotherapy modalities.
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http://dx.doi.org/10.1055/a-2187-7263 | DOI Listing |
Pediatr Radiol
December 2024
Department of Pediatric Radiology, Hospital da Criança e Maternidade, 60 Jamil Feres Kfouri Ave, São José do Rio Preto, São Paulo, 15091-240, Brazil.
Ascariasis is a prevalent intestinal helminthic infection caused by Ascaris lumbricoides, commonly known as roundworm. While the disease may remain asymptomatic when the parasites are confined to the intestinal lumen of the small bowel, symptoms and complications can arise when the helminths invade the biliary tree or pancreatic ducts. In cases of severe infection, a mass of roundworms can lead to intestinal complications, such as bowel obstruction.
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Department of Surgery, Mubarak Al-Kabeer Hospital, Kuwait City, Kuwait.
The development of an arterial pseudoaneurysm is an unusual complication of chronic pancreatitis. The most commonly involved artery is the splenic artery. This is a case report describing a case of a superior pancreaticoduodenal artery pseudoaneurysm in a patient with chronic pancreatitis who developed .
View Article and Find Full Text PDFAnn Surg Oncol
December 2024
Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: Pancreatic enucleation is a reliable surgical method for treating benign and borderline pancreatic tumors; however, the incidence of postoperative pancreatic fistula (POPF) is high, especially when the tumor is close to the main pancreatic duct. This study aimed to reduce the incidence of pancreatic fistula by preoperative placement of pancreatic stents and to summarize our center's experience with this procedure.
Methods: From June 2020 to July 2023, patients diagnosed with benign or borderline pancreatic tumors at Renji Hospital were included.
BMC Surg
December 2024
Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary.
Background: Biliary leakage is a serious complication of hepato-pancreato-biliary operations, increasing morbidity and mortality, and challenging clinicians.
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BMC Cancer
December 2024
The Fourth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, China.
Ampullary carcinoma (AC) of the intestinal type represents a distinct variant within the broader category of ampullary neoplasms. The scarcity of pertinent cellular models has constrained investigations centered on this particular malignancy. This research effectively generated a cell line (CL) of intestinal-type AC (DPC-X3).
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