Digital Catheter Based Pancreatoscopy (SpyGlassDS) for the Management of Symptomatic Pancreatic Duct Stones in Selected Patients With Chronic Pancreatitis

Inclusion Criteria: * Eligible patients are adults (≥ 18 years of age) with a signed informed consent with: * symptomatic chronic pancreatitis (recurrent pain attacks, history of pain for at least 3 months), and * ≤3 radiopaque stones ≥5mm obstructing the MPD in the pancreatic head and/or corpus. Exclusion Criteria: * \- Health status ASA 4 * Pregnancy * Coagulopathy (INR≥2.0, Platelets \< 70/nl) * Taking anti-platelet agents or anticoagulants (other than aspirin) within last 7 days * Any medical contraindication to ERCP, deep sedation or general anesthesia * History of chronic symptomatic pancreatitis of more than 3-4 years\[9\] * History of daily use of opioids except Tramadol for more than 6 months in the last 2 years * Episode of biliary obstruction in the previous 2 months (defined as jaundice or bilirubin levels \>=2,5mg/dl or CBD stent * Auto-Immune Pancreatitis or IgG4 associated pancreatitis * Altered GI anatomy, previous failures of endoscopic approach to the papilla * Abdominal pain not attributable to CP * Any suspicion of pancreatic cancer * Current symptomatic WON * More than one ductal stricture in the pancreatic head or body * Previous ESWL pancreatic stones * Age \<18