Pancreatic Sphincter Precutting using a Dual Knife to Relieve Acute Pancreatic Duct Obstruction

A 47-year-old woman diagnosed with chronic pancreatitis was admitted to our hospital. Computed tomography (CT) revealed main pancreatic duct (MPD) dilatation with multiple calcifications (Fig. 1a). Pancreatic extracorporeal shock wave lithotripsy (P-ESWL) was performed for stone disintegration starting from the pancreatic head (Fig. 1c). After P-ESWL, the patient complained of intense abdominal pain. Intramuscular injection of pethidine was repeatedly applied but did not relieve the pain. Repeated CT revealed that the diameter of the MDP had increased from 8.11mm to 17.99mm (Fig.

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