1983 Volume 25 Issue 8 Pages 1246-1253
A forty-two year-old man with chronic relapsing pancreatitis presented with severe abdominal pain. Clinical examination such as ultrasonography (US), CT and ERCP revealed pseudocyst in the body of the pancreas. Calcification was not observed in abdominal plain x-ray film or CT, but ERCP revealed filling defect floating in the main pancreatic duct in the head of the pancreas, and the case was diagnosed as non-calcified pancreatolithiasis. While the clinical course was followed up by US, CT and ERCP, pseudocyst disappeared within about a month. After one year, attack of pancreatitis recurred. In order to relieve the intraductal pancreatic pressure and to remove the stone, endoscopic sphincterotomy to the pancreatic duct was performed according to the method of sphincterotomy described by Warren, or to the methods of sphincteroplasty described by Jones et al. or Nardi. After performing the usual endoscopic papillotomy, a papillotome was inserted into the pancreatic orifice and an incision was made in the manner of pulling in the 12° direction. The pancreatic stone was grasped by a basket catheter under fluoroscopy, and removed. His clinical course is presently under obsevation with no complication.
