Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Dig Endosc. 2010 Oct;22(4):345-7. doi: 10.1111/j.1443-1661.2010.01029.x.
Pancreatic duct stones are a common complication of chronic pancreatitis. We describe successful endoscopic removal of a large pancreatic duct stone using large-balloon dilation in combination with pancreatic sphincterotomy. A 63-year-old woman was admitted for endoscopic treatment of acute on chronic pancreatitis with diabetes and epigastric pain with liver dysfunction due to a large impacted stone within the distal main pancreatic duct. Endoscopic pancreatic sphincterotomy was carried out using a wire-guided pull-type sphincterotome. Although we could carry out a relatively large incision, the stone could not be extracted. We therefore carried out papillary dilation using a large balloon (diameter 12 to 15 mm) to make room alongside the stone. A 10 × 20-mm white pancreatic duct stone was extracted during the process of pulling a dilating balloon into the working channel of the endoscope. Eventually, the second stone was removed without any procedure-related complication.
胰管结石是慢性胰腺炎的常见并发症。我们描述了一例使用大球囊扩张联合胰管括约肌切开术成功取出胰管大结石的病例。一位 63 岁女性因糖尿病和上腹痛、肝功能异常入院，经内镜诊断为慢性胰腺炎伴发急性发作，主胰管下段有一巨大嵌顿结石。采用导丝引导的拉式括约肌切开刀进行内镜下胰管括约肌切开术。尽管我们能够进行相对较大的切口，但结石仍无法取出。因此，我们使用大球囊（直径 12-15mm）进行乳头扩张，在结石旁边腾出空间。在将扩张球囊拉入内镜工作通道的过程中，取出了 10×20mm 的白色胰管结石。最终，在没有任何与操作相关的并发症的情况下取出了第二块结石。
