To evaluate the efficacy and safety of endoscopic retrograde cholangio-pancreatography (ERCP) in the treatment of pancreatic duct stones (PDS).

Clinical data of one PDS patient treated with ERCP in Lanzhou University Second Hospital in October 2019 were retrospectively analyzed. The informed consent of this patient was obtained and the local ethical committee approval was received. The male patient, aged 72 years old, was admitted to hospital on October 23, 2019 due to "upper abdominal discomfort for 10 d". No skin and sclera yellowing, upper abdominal tenderness were found in physical examination without rebound pain, Murphy sign, and bowel sounds was 3 times/min. He had a history of type 2 diabetes mellitus for 10 years and chronic pancreatitis for years. Upon admission, the blood glucose level was 16.7 mmol/L. PDS was diagnosed by CT, MRI and MRCP. ERCP was performed on October 28, 2019.

Under ERCP, the duodenal papilla sphincterotomy was performed, and the pancreatic duct opening and proximal pancreatic duct were dilated by cylindrical balloon. White silt-like stones were cleaned up with balloon cleaning. A 7.5-cm pancreatic duct stent was placed along the guidewire stent, and a plastic stent was placed in the bile duct. The bile and pancreatic fluid could be excreted smoothly. After the operation, the patient received anti-inflammation and symptomatic treatments, and then discharged. The patient recovered well after operation and maintained normal diet without abdominal pain, and the blood glucose level was properly controlled. CT reexamination at postoperative 3 months showed that the pancreatic duct was unobstructed and no recurrence of PDS. The patient recovered well at postoperative 6-month follow-up.

Precise individualized treatments should be adopted according to the location, size and quantity of PDS, as well as the anatomical changes of pancreatic duct. ERCP lithotripsy with stent placement is the optimal choice for patients with one stone lesion in the main pancreatic duct.