Operative transampullary extraction of pancreatic calculi.

Transduodenal sphincteroplasty (TDS) was performed upon five patients with chronic pancreatitis shown on endoscopic retrograde cholangiopancreatography to have stones in the pancreatic ductal system. Stone removal was achieved after TDS using either a Fogarty balloon catheter, a Dormia basket or surgical forceps. All had suffered from a two to three year history of severe pain and weight loss which was relieved in each after stone removal. One patient suffered recurrent pain in the follow-up period of 21 to 45 months (a median of 35 months) and a recurrent stone in the pancreatic duct was removed endoscopically using a Dormia basket. Contrary to widely held views, TDS and simple stone extraction have a place in the management of some patients with chronic pancreatitis.