title: Dilation of refractory pancreatic duct strictures: the turn of the screw.
abstract: BACKGROUND
  Endoscopic pancreatic ductal drainage may improve pain from chronic pancreatitis but stricture dilation may be technically difficult.
  
  
  METHODS
  Eight patients with refractory pancreatic strictures had dilation with a Soehendra stent retriever. Each had sphincterotomy, guidewire placement, stent retriever dilation to 7F to 10F, and stenting for 6 to 12 months.
  
  
  RESULTS
  All procedures were successful and 1 (13%) was complicated by mild pancreatitis. The mean follow-up was 21 months. Each patient had substantial pain relief with patent stents in place, but 7 (88%) relapsed with stent occlusion or removal. Four (50%) patients underwent surgery with excellent results. However, endoscopic therapy alone resulted in just modest benefits or pain recurrence in 3 (38%) and persistent relief in only 1 (13%).
  
  
  CONCLUSIONS
  The Soehendra stent retriever is effective as a dilating device for pancreatic strictures resistant to conventional dilation. However, substantial symptom relief may persist only while patent stents are in place.
authors.affiliation: University of Utah Health Sciences Center and Veterans Affairs Medical Center, Salt Lake City, Utah 84132, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Ziebert
authors.forename: J A
authors.initials: JA
authors.lastname: DiSario
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D004106:Dilatation / Q000295:instrumentation* / Q000379:methods; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000150:complications / Q000628:therapy; D015607:Stents