Pancreatic duct stone management strategies: Advances and clinical practice in chronic pancreatitis

Table 1 Summary of benefits and risks of endoscopic procedures for pancreatic duct stones

	Key benefits	Key risks/limitations
ERCP for stone extraction	Primary intervention for PDS; enables direct removal of small stones (≤ 0.5 cm); provides access for fragment removal post-ESWL	Risk of PEP; ineffective for large/impacted stones without prior fragmentation (requiring ESWL); risk of procedure failure (e.g., guidewire placement increasing risk of residual stones)
Pancreatic duct stenting	Achieves decompressive drainage; alleviates pain associated with chronic pancreatitis and ductal obstruction; bridges obstructed segments when immediate stone removal is not feasible	Risk of stent-induced ductal changes (strictures/dilatation); complications include proximal/distal migration, stent occlusion, and rare events like jejunal obstruction; may require subsequent removal procedure

PDS: Pancreatic duct stones; ERCP: Endoscopic retrograde cholangiopancreatography; ESWL: Extracorporeal shock wave lithotripsy; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.