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

BackgroundEndoscopic 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.ObjectiveTo 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.DesignA prospective feasibility study.SettingTertiary-care center.PatientsThis study involved 10 patients with main pancreatic duct stones of 5 mm or less in the shorter diameter of the largest stone.InterventionIn 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 MeasurementsSuccess rate of removal of the target stones and procedure-related adverse events.ResultsA 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.LimitationsA small sample size without a control group.ConclusionThis novel nitinol basket catheter is useful for the extraction of small pancreatic stones. A randomized, controlled trial is warranted to confirm its efficacy.