Recanalization using a novel drill-shaped dilator for a severe pancreatic duct stricture and impacted pancreatic duct stone

Pancreatic duct stones can cause severe acute pancreatitis and are sometimes fatal. Endoscopic pancreatic duct drainage has been established as a first-line treatment [1] [2]; however, hard stones can make passing through strictures challenging. A Soehendra stent retriever with a screw tip (SSR-7; Cook Medical, Tokyo, Japan) may be useful in this situation [3], but a serious complication can occur should the tip of the stent retriever detach and migrate into the pancreatic duct [4]. A novel dilator with a unique shape was recently developed (Tornus ES for 0.025-inch guidewire; 7 Fr, stainless steel; Asahi Intecc, Aichi, Japan) [5] ([Fig. 1]). This drill-shaped dilator can be rotated to break through strictures. Here, we describe recanalization using this novel drill-shaped dilator for a patient with severe pancreatic duct stricture and an impacted pancreatic duct stone ([Video 1]).