In this report, we described the management of a patient with refractory Main Pancreatic Duct (MPD) stricture. The case was characterized by dominant stricture of the MPD that persisted for more than a year even after plastic stenting. The patient relapsed with symptoms of chronic pancreatitis and features of obstructive pancreatitis. In addition to the case description, we have reviewed the topic and explained the role of pancreatoscopy in the management of refractory MPD stricture and stone extraction from the MPD. Eventually, with the help of pancreatoscopy, the stricture was dilated, and stents were placed. The patient improved after following extraction of stones, MPD stricture dilation, and pancreatic stenting treatment.
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