Long-term results of endoscopic stenting and surgical drainage for biliary stricture due to chronic pancreatitis.
A retrospective evaluation was made of the long-term results of endoscopic stenting in 58 patients with benign biliary stricture due to chronic pancreatitis. Immediate relief of jaundice and cholestasis was achieved in all patients after endoscopic stent insertion. Median follow-up was 49 months. Five (9 per cent) of the 58 patients had complications following therapeutic endoscopic retrograde cholangiopancreatography. Late stent-related complications occurred in 37 (64 per cent) of 58 patients. There were no deaths. Sixteen (28 per cent) of the 58 patients had regression of the biliary stricture and permanent removal of the stent. Forty-two patients had persistent biliary stricture: 26 had continued stenting and 16 underwent surgical procedures. Early morbidity after surgery was found in six of 16 patients, with no deaths. Postoperative relief of jaundice was achieved in 15 of the 16 patients. In conclusion, endoscopic stenting and surgery are both effective treatments for biliary stricture in patients with chronic pancreatitis. Endoscopic stenting is associated with fewer early complications. However, late stent-related complications remain a major limitation. Endoscopic stenting offers definitive treatment in more than one-quarter of patients (28 per cent).
Smits
M E
ME
Department of Gastroenterology and Hepatology, University of Amsterdam, The Netherlands.
Rauws
E A
EA
van Gulik
T M
TM
Gouma
D J
DJ
Tytgat
G N
GN
Huibregtse
K
K
D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D002908:Chronic Disease; D004322:Drainage / Q000379:methods*; D004724:Endoscopy; D004866:Equipment Contamination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome