Publication Name	World Journal of Gastrointestinal Endoscopy
Manuscript ID	122451
DOI	10.4253/wjge.122451
Country	United States

Category	Gastroenterology & Hepatology
Manuscript Type	Minireviews
Article Title	Pancreatoscopy guided lithotripsy for difficult pancreatic duct stones: Evidence and treatment selection in chronic pancreatitis
Manuscript Source	Invited Manuscript
All Author List	Rintaro Hashimoto
Funding Agency and Grant Number
Corresponding Author	Rintaro Hashimoto, Assistant Professor, MD, PhD, Department of Internal Medicine, University of Iowa Health Care, 200 Hawkins Dr, Iowa City, IA 52242, United States. rintaro-hashimoto@uiowa.edu
Key Words	Chronic pancreatitis; Pancreatic duct stones; Pancreatoscopy guided lithotripsy; Extracorporeal shock wave lithotripsy; Patient selection
Core Tip	Pancreatoscopy-guided lithotripsy has become a useful option for difficult pancreatic duct stones, but the available evidence does not justify replacing extracorporeal shock wave lithotripsy as the default strategy. Its role should be decided case by case. Stone size, computed tomography attenuation, radiopacity, overall stone burden, duct anatomy, downstream strictures, access route, local expertise, and the expected number of procedures all matter. Success should also be measured beyond duct clearance. Pain relief, quality of life, opioid use, hospitalizations, need for repeat intervention, nutritional status, pancreatic function, and timely referral for surgery should all be part of treatment selection. In this setting, duct clearance is only one outcome; the more important question is whether treatment changes the patient’s clinical course.
Citation	Hashimoto R. Pancreatoscopy guided lithotripsy for difficult pancreatic duct stones: Evidence and treatment selection in chronic pancreatitis. World J Gastrointest Endosc 2026; In press DOI: https://doi.org/10.4253/wjge.122451
PDF	122451-in-press.pdf

Received	2026-04-20 08:24
Peer-Review Started	2026-04-20 08:25
First Decision by Editorial Office Director	2026-06-04 10:39
Return for Revision	2026-06-05 03:38
Revised	2026-06-06 02:14
Publication Fee Transferred
Second Decision by Editor	2026-07-20 02:35
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-07-20 06:08
Articles in Press	2026-07-20 06:08
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5190 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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