Pancreatic Ductal stricture with Stone

A 63 year male diabetic patient had complaints of pain abdomen with radiation to the back.He was investigated with MRCP showing a 5mm main pancreatic duct with stone in the neck and upstream dilatation.The pancreas was atrophic.CBD,GB were normal.

ERCP was performed.Selectuve cannulation was done of the pancreatic duct .The wire could negotiate the stricture in the neck but even a 5 Fr biliary dilator could not.A stent retriever was screwed over the wire and the stricture dilatation obtained with removal of fragments of stone.A pancreatic stent was placed .

The stent was removed after 2 months to obtain free pancreatic duct drainage.The patient was pain free.