Endoscopic pancreatic stent drainage improves pain in chronic pancreatitis.
Pain in chronic pancreatitis is due to intraglandular neural affection and to pancreatic duct drainage obstruction with an increased intraductal pressure. To achieve pain relief, medical, surgical and endoscopic procedures have been developed.


OBJECTIVE
To evaluate the efficacy of pancreatic duct stenting in patients with narcotic-dependent pain due to chronic pancreatitis.


METHODS
From May-1994 to May-1996, ten patients (medium age: 47.5 yr) with alcoholic chronic pancreatitis were selected for this procedure. Pancreatography showed single or multiple Wirsung strictures in all cases. Papillotomy and pancreatic duct sphincterotomy were performed before stenting. Strictures were negotiated with a 7F dilating catheter over a guide wire, and intraductal calculi were removed as well. We used 7F plastic stents with variable lengths (5-10 cm), that were exchanged when the patient presented pain recurrence. Stent survival time was defined as the patient's pain-free time.


RESULTS
In 6 of the 10 patients stent placement was carried out successfully. A single distal Wirsung stricture was diagnosed in 3 patients while in the remaining 3 there were several strictures associated to ductal lithiasis in two of them. Mean time to achieve pain relief was 3 days and mean stent survival time was 166.5 days. There were no complications due to the procedure.


CONCLUSIONS
When placed through the stricture, endoscopic pancreatic stent drainage is effective in achieving pain relief. It is a safe procedure with no complications in our short series.
Pellicer Bautista
F
F
Service of Digestive Diseases, Virgen Macarena Universitary Hospital, Sevilla, Spain.
Fernández Pérez
F J
FJ
Martín Guerrero
J M
JM
Pallarés Manrique
H
H
Hassan Asad
M
M
Romero Castro
R
R
Hergueta Delgado
P
P
Herrerías Gutiérrez
J M
JM
D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000209:etiology / Q000628:therapy; D010183:Pancreatic Ducts; D019512:Pancreatitis, Alcoholic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D015607:Stents