File name .JPG
File alt. text
Image should be px wide x px tall.
Select Image
home - Pancreas - Other - Pancreatic Stones Written by Dr Sebastian Zeki

Pancreatic Stones

Methods 3 methods Spark discharge (Dornier system)Piezoelectric elements (Wolf system)Electromagnetic deflection of a metal membrane (Siemens system) Lithotriptors (concentrated, ultrasound guided shock waves focussed on stones) Pain relief- 70% Success endpoints (overall success rate of fragmentation= 85%):-Dec x-ray stone density-Inc stone surface area-Heterogeneity of the stone (looks powdered)-Relief of ductal obstruction demonstrated 1. Locate (MRCP with secretin or CT. USS not precise enough 2. Deliver 3000-5000 SW’s over 50 minutes. Start with most distal first. 3. ERCP Flush whilst moving the basket along duct. A 6-F nasopancreatic catheter should be left in place for1 or 2 days and perfused with an isotonic saline solution (1L every 24 hours) to eliminate stone fragments. Indications in Pancreatic Stone:sRecurrent pancreatic pain with moderate to marked pancreatic duct dilatation and obstructive ductal stones (calcified or radiolucent). Contraindications:Coagulation disorders.Bone, calcified aneurysms, or lung tissue in the SW path. Factors Associated with Pain Relief:Stones in head of pancreasSmoking cessation or absence.Factors Not Associated with Pain Relief:The number and location of stonesPresence of a strictureContinued alcohol use Pancreatic Stone Therapy Efficacy Other benefits:It can prevent fibrosis therefore exocrine insufficiency.Improves function in those with exocrine insufficiency.Stone Recurrence Rate: 50%.Complications: Rare. Written by Dr Sebastian Zeki Ideal Candidates: Dilated main pancreatic duct which contains a single stone but has no stricture.