Pancreatic stent placement for duct disruption.
BACKGROUND
The aim of this study was to identify predictors of outcome after pancreatic duct stent placement for duct disruption.


METHODS
Patients were identified from endoscopy databases. Disruption was defined by extravasation of contrast from the pancreatic duct during endoscopic retrograde pancreatography. Data collected included demographic information, imaging studies, management before and outcome after stent placement. Success was defined as resolution of the disruption clinically, on radiologic imaging, and/or at endoscopic retrograde pancreatography.


RESULTS
Forty-three patients (23 women, 20 men; mean age 57 years, [SD] 15.2 years) were studied. The etiology of pancreatic duct disruption was acute pancreatitis in 24, chronic pancreatitis in 9, operative injury in 7, and trauma in 3 patients. In 25 patients there was resolution of the disruption, whereas stent therapy was unsuccessful in 16 and the outcome was indeterminate in 2 patients. On univariate analysis, stent positioned to bridge the disruption (p = 0.04) and longer duration of stent therapy (p = 0.002) were associated with a successful outcome. Female gender (p = 0.05) and acute pancreatitis (p = 0.05) were associated with a lack of success. On multivariate analysis, only the bridging stent position remained correlated to outcome. Complications occurred in 4 patients.


CONCLUSIONS
A bridging stent is associated with a successful outcome after pancreatic duct stent placement for duct disruption.
Telford
Jennifer J
JJ
Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Farrell
James J
JJ
Saltzman
John R
JR
Shields
Steven J
SJ
Banks
Peter A
PA
Lichtenstein
David R
DR
Johannes
Richard S
RS
Kelsey
Peter B
PB
Carr-Locke
David L
DL
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000293:injuries; D010195:Pancreatitis / Q000150:complications; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome