Dissection of a refractory pancreatic-duct stricture by using a pre-cutting needle-knife

Abstract

Endoscopic deployment of a pancreatic stent may reduce the severity of abdominal pain for selected patients with chronic pancreatitis.1-3 However, the endoscopic therapy of chronic pancreatitis is sometimes difficult. When the stricture of the pancreatic duct is very severe and only the guidewire can pass across it, successful stent deployment is not possible. A Soehendra stent extractor (Wilson-Cook Medical Inc, Winston-Salem, NC) may be used for such a refractory stricture.4,5 In this report, we demonstrate the application of a pre-cutting needle-knife as an alternative to a Soehendra stent extractor to dissect a refractory stricture in the pancreatic duct of a patient with severe chronic pancreatitis, as well as the outcome of this procedure, in a 1.5-year follow-up.