Pancreatic duct stones and laser treatment: A case report

Filipa Ribeiro Lucas 1, *, Soraia Proença e Silva 1 and João Gigante 2

1 Internal Medicine, Castelo Branco Hospital, Castelo Branco, Portugal.
2 Clinical Pathology, Prof. Doutor Fernando da Fonseca Hospital, Lisbon, Portugal.
 
Case Study
World Journal of Advanced Research and Reviews, 2021, 12(03), 001–004
Article DOI: 10.30574/wjarr.2021.12.3.0655
 
Publication history: 
Received on 24 October 2021; revised on 01 December 2021; accepted on 03 December 2021
 
Abstract: 
A 62 years-old Caucasian male, who had a consumptive condition associated with recurrent episodes of abdominal pain, was evaluated in a Gastroenterology consultation.
Physical examination was quite innocent and the following imaging exams were performed. A Computed Tomography (CT) showed a thin gallbladder and chronic pancreatitis signs with pancreatic intraductal stones, dominant at tail and body, associated with pancreatic tail atrophy. An abdominal-Magnetic Resonance Imaging (MRI) showed an abnormal pancreatic parenchyma, a mild Wirsung dilatation and an unknown pancreatic head stenosis etiology. Therefore, to clarify the pancreatic stenosis, an echo-endoscopy (EUS) was performed. This exam showed a 10-mmstone associated with a focal narrowing in the head/tail transition.
A pancreatoscopy-guided holmium laser using a mini-endoscope inserted into the pancreatic duct successfully broke the impacted stone and cleared the obstruction, without complications. After that, endotherapy with plastic stents was repeatedly done, during the following 6 months.
After endoscopic treatment, the patient recovered quite well, without any symptoms, without pancreatic stenosis and higher quality of life.
 
Keywords: 
Chronic pancreatitis; Holmium laser; Pancreatic duct stone; pancreatoscopy
 
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