A novel basket catheter to facilitate endoscopic removal of pancreatic stones (with video)

作者：Sasahira Naoki; Isayama Hiroyuki^*; Tokyokawa Yoshihide; Mizuno Suguru; Hirano Kenji; Nakai Yousuke; Sase Risa; Kogure Hirofumi; Sasaki Takashi; Yamamoto Natsuyo; Tada Minoru; Koike Kazuhiko

来源：Gastrointestinal Endoscopy, 2013, 78(6): 925-929.

DOI：10.1016/j.gie.2013.07.041

Background: Endoscopic removal of pancreatic stones in patients with chronic pancreatitis is still challenging. With a conventional basket catheter, introduction to the target area or catching pancreatic stones is sometimes difficult.
Objective: To evaluate a novel double-lumen basket catheter composed of nitinol wires with fine reticular structures in the distal end and loose mesh in the proximal part. Design: A prospective feasibility study.
Setting: Tertiary-care center.
Patients: This study involved 10 patients with main pancreatic duct stones of 5 mm or less in the shorter diameter of the largest stone.
Intervention: In the first 5 cases, a nitinol basket catheter was used as salvage after stone extraction with a conventional basket catheter and retrieval balloon (salvage group). In the following 5 cases, stones were initially removed by using a nitinol basket catheter, and the presence of residual stones was evaluated by pancreatogram along with balloon sweep (initial group).
Main Outcome Measurements: Success rate of removal of the target stones and procedure-related adverse events.
Results: A nitinol basket catheter was easily introduced to the target stone in all patients. In the salvage group, additional stones were retrieved with a nitinol basket catheter in 3 of 5 patients. In the initial group, stone extraction by a nitinol basket catheter was successful, and no residual stones were extracted by additional balloon cleaning in any patients. Basket impaction or after-ERCP pancreatitis was not observed.
Limitations: A small sample size without a control group.
Conclusion: This novel nitinol basket catheter is useful for the extraction of small pancreatic stones. A randomized, controlled trial is warranted to confirm its efficacy.

• 出版日期2013-12