Endoscopic pancreatic drainage in chronic pancreatitis.
A nasopancreatic drain, pancreatic duct endoprostheses, and pancreatic stone extraction were used to treat 32 patients with chronic pancreatitis. Thirty patients were treated endoscopically. Endoscopic treatment via the minor papilla in 2 patients with pancreas divisum was not performed. Three patients had subsequent surgery because of complications; one of them died. Seventeen patients with chronic relapsing pancreatitis improved, with 15 patients asymptomatic during a follow-up of 2 to 69 months (median, 11). Seven of 10 patients with chronic pain improved, with 6 patients pain-free during a follow-up of 10 to 34 months (median, 11). In 7 patients, pancreatic pseudocysts could be drained endoscopically by positioning an endoprosthesis into the cyst or by performing a cystoduodenostomy. Six patients had concomitant placement of a biliary endoprosthesis to treat common bile duct strictures within the pancreatic head. One of 32 treated patients died as a result of a complication. We consider endoscopic therapy a viable alternative to surgery in select patients with chronic pancreatitis.
Huibregtse
K
K
Department of Gastro-Entero-Hepatology, University of Amsterdam, The Netherlands.
Schneider
B
B
Vrij
A A
AA
Tytgat
G N
GN
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010195:Pancreatitis / Q000601:surgery*; D011183:Postoperative Complications; D019736:Prostheses and Implants; D012008:Recurrence; D013105:Sphincterotomy, Transduodenal