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Spyglass-guided Lithotripsy Versus ESWL for Pancreatic Duct Stones

Not Applicable
Conditions
Pancreatic Duct Stone
Registration Number
NCT05475782
Lead Sponsor
First People's Hospital of Hangzhou
Brief Summary

Overall stone clearance with endoscopic retrograde cholangiopancreatography (ERCP) for pancreatic duct stones is a amjor problem, especially bigger size stones. After ERCP failure, surgery was the only option but patients not suitable for surgery were treated through stenting. But had to undergo multiple ERCPs and show lower success rate. Recently, SpyGlass and extracorporeal shock wave lithotripsy (ESWL) have been applied for the treatment of huge stones. The present study aims to compare the efficacy and safety outcomes of SpyGlass-guided lithotripsy and ESWL procedures for the removal of pancreatic duct stones.

Detailed Description

ESWL was first used for the removal of renal calculi and ureteral calculi however, now a day is being used for pancreatic duct stones and biliary calculi. It has the advantages of simple operation, lower cost, and higher safety. Recent studies show that the procedure time for ESWL is also shorter and the utilization rate of mechanical lithotripsy was effectively reduced with fewer complications. But It is difficult for ESWL to break the stones larger than 3cm into small pieces.

Spyglass has been used in clinics for more than ten years. Recently, a study reported difficult bile duct stones that were treated with SpyGlass-guided laser lithotripsy that shows promising results. Compared with laser lithotripsy under X-ray monitoring, there is no significant difference in stone removal rate and complication rate between the two methods. However, the effect of lithotripsy under Spyglass direct vision is better, which can break large stones into smaller pieces, thus making it easier to take stones. Investigator conducted the current study to compare the therapeutic outcome and complications between SpyGlass direct vision lithotripsy and ESWL procedures for the removal of large pancreatic duct stones.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Pancreatic duct sone
  • Falied to eliminate through ERCP only
Exclusion Criteria
  • Pregnancy
  • Refusal of written informed consent
  • Patients not suitable for ESWL/ Spyglass
  • Contraindications to ERCP exist
  • Complicated with acute pancreatitis or acute cholangitis
  • Coagulation dysfunction#thrombocytopenia
  • Patients after gastrointestinal reconstruction
  • Allergic to drugs

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Technical successIntraoperative

Successfull intervention

Clinical success1 month

Pancreatic duct stone clearance rate

Secondary Outcome Measures
NameTimeMethod
Adverse events1 month

procedure related adverse events, bleeding, pancreatitis, etc

Total number of ERCP1 month

Number of ERCPs performed for stone clearnce

Procedure sessions1 month

Total sessions of therapy

Trial Locations

Locations (1)

Hangzhou First People's Hospital

🇨🇳

Hangzhou, Zhejiang, China

Hangzhou First People's Hospital
🇨🇳Hangzhou, Zhejiang, China

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