title: Outcome of pancreaticojejunostomy after previous endoscopic stenting in patients with chronic pancreatitis.
abstract: OBJECTIVE
  To assess whether previous endoscopic stenting of the pancreatic duct influences the outcome of subsequent pancreaticojejunostomy in chronic pancreatitis.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  University hospital, the Netherlands.
  
  
  METHODS
  50 patients with chronic pancreatitis, 26 of whom had previously had stents inserted and 24 who had not.
  
  
  METHODS
  A questionnaire was sent to each patient to evaluate long-term pain relief, readmissions during follow-up and subjective efficacy of the operation, and risk factors for recurrent pain were calculated.
  
  
  METHODS
  Postoperative morbidity, pain relief and subjective efficacy.
  
  
  RESULTS
  Patients with stents were operated on later (after 60 months of symptoms) than those without (17 months). 5 (19%) and 2 (8%) patients developed complications. No patient died. Personal follow-up (median 27 months) was obtained in 41 of 44 available patients (93%). 36 patients (88%) felt that they had benefited from pancreaticojejunostomy. 13 of the 21 patients with stents (62%) and 11 of the 20 patients without stents (55%) reported pain at least monthly, but of these 24 patients 21 patients (88%) had less pain than preoperatively; 11 (22%) had pain daily. 13 patients were readmitted for a relapse of pancreatitis, 3 of whom required partial pancreatectomy. Previous endoscopic stenting of the pancreatic duct was not a risk factor for recurrent pain (p = 0.61).
  
  
  CONCLUSIONS
  Endoscopic stenting of the pancreatic duct may be done for patients with chronic pancreatitis without adverse effects on the outcome of subsequent pancreaticojejunostomy.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. djamilaboerma@hotmail.com
authors.forename: Djemila
authors.initials: D
authors.lastname: Boerma
authors.forename: Thomas M
authors.initials: TM
authors.lastname: van Gulik
authors.forename: Erik A J
authors.initials: EA
authors.lastname: Rauws
authors.forename: Huug
authors.initials: H
authors.lastname: Obertop
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Gouma
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000601:surgery; D010183:Pancreatic Ducts / Q000601:surgery; D010193:Pancreaticojejunostomy; D010195:Pancreatitis / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome