Advanced Endoscopy Fellows Program | September 2023-Presentation 4A - Endoscopic Pancreatic Disease Discussions 1

Presentation 4A - Endoscopic Pancreatic Disease Discussions 1

Video Transcription

Video Summary

The video discusses a case of a 34-year-old woman with recurrent pancreatitis. The patient had multiple comorbidities and presented with acute recurrent pancreatitis. The differential diagnosis included malignancy, divisum, sickle cell disease, ischemia, and complications from chronic renal failure. Imaging showed new pancreatic duct dilation with filling defects in the head. Additional imaging with MRCP confirmed a small pancreatic duct stone and upstream dilation. The endoscopic retrograde cholangiopancreatography (ERCP) procedure was performed to remove the stones. The video highlights the challenges in accessing the pancreatic duct and the use of various techniques, including balloon dilation and stone extraction. The stones were successfully removed, and post-procedure imaging showed no filling defects. Factors for long-term success in endotherapy include short disease duration, non-severe pain, cessation of smoking and alcohol, complete removal of stones, and addressing strictures before intervention. Other therapies, such as lithotripsy or pancreatoscopy, may be considered for larger stones or difficult cases.

Keywords

recurrent pancreatitis

differential diagnosis

pancreatic duct dilation

stone extraction

endotherapy

pancreatoscopy