[Endoscopic treatment of pancreatitis and its complications].
OBJECTIVE
To study the long- and short-term safety and efficacy of endoscopic treatment of pancreatitis and its complications in our environment.


METHODS
We performed a retrospective analysis of 43 patients with chronic pancreatitis, acute pancreatitis complicated with pseudocyst, and pancreatic fistula diagnosed by endoscopic retrograde cholangiopancreatography who were suitable for endoscopic treatment.


RESULTS
Endoscopic treatment was attempted in 35 patients. The indication for treatment was pain in 17 patients (48.5%), jaundice in 7 (20%), pseudocyst in 10 (28.5%) and suspected external fistula in 1 (3%). The technique was successfully performed in 28 (80%). Of the patients with pain, pancreatic prosthesis was inserted in 13 and extracorporeal lithotripsy was applied in 6. Sixty-five percent of the patients improved. Of the 7 patients with jaundice, all had secondary stenosis of the biliary tract. Treatment was applied in 2, who showed partial improvement. Of the 15 patients with pseudocyst, endoscopic treatment was indicated in 10; the technique was successfully performed in 8 and complete resolution was achieved in 7 (87.5%). The patient with external fistula was treated with transpapillary prosthesis and complete resolution of disruption of Wirsung's duct was achieved. Overall improvement in successfully treated patients was: complete in 19 (68%), partial in 3 (18%), no improvement in 4 (14%) and 2 patients were lost to treatment. There were 4 short-term complications. There were 4 deaths and one was related to the technique.


CONCLUSIONS
Endoscopic treatment of chronic pain in chronic pancreatitis, pseudocysts and fistulas was effective in our environment with a low rate of complications.
Aguilera
V
V
Servicio de Medicina Digestiva. Hospital Universitario La Fe. Valencia. España. toyagui@hotmail.com
Mora
J
J
Sala
T
T
Martínez
F
F
Palau
A
A
Bastida
G
G
Argüello
L
L
Pons
V
V
Pertejo
V
V
Berenguer
J
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002760:Cholangiopancreatography, Endoscopic Retrograde; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000628:therapy; D002908:Chronic Disease; D003251:Constriction, Pathologic; D004106:Dilatation; D004322:Drainage; D004385:Duodenostomy; D004724:Endoscopy; D005260:Female; D005774:Gastrostomy; D006801:Humans; D020347:Lithiasis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010183:Pancreatic Ducts / Q000473:pathology / Q000601:surgery; D010185:Pancreatic Fistula / Q000628:therapy; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000628:therapy; D010195:Pancreatitis / Q000150:complications / Q000601:surgery / Q000628:therapy*; D011183:Postoperative Complications; D011292:Premedication; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic
D000900:Anti-Bacterial Agents