Outcome following endoscopic stenting of pancreatic duct strictures in chronic pancreatitis.
OBJECTIVE
To assess outcomes following 6 months of endoscopic stenting for dominant pancreatic duct strictures in painful chronic pancreatitis.


BACKGROUND
Pancreatic stent placement may improve pain in chronic pancreatitis. Long-term outcomes after a 6-month period of stenting are unknown.


METHODS
We identified all patients with chronic pancreatitis who underwent stenting of a dominant pancreatic duct stricture at one hospital. Stents were left in place for 6 months. Changes in weight, hospital visits, and narcotic use were analyzed.


RESULTS
Mean follow-up for the 15 subjects was 36 months; 87% improved following stent placement, and 11 (73%) completed 6 months of stent therapy. Hospital visits per subject decreased from 3.6 in the year prior to stent placement to 0.1 in the year after stent removal (P < 0.01). Oral narcotic use decreased from 33 mg MSO4/day in the month prior to stenting to 2 mg MSO4/day in the 12 months after stent removal (P = 0.01). Mean weight change was -5 kg in the year prior to stenting and +3.2 kg in the year after stent insertion (P < 0.01); 36% required endoscopic reintervention during the follow-up period.


CONCLUSIONS
Six months of stenting resulted in sustained clinical improvement in most patients with chronic pancreatitis and a dominant pancreatic duct stricture. Stenting was associated with subsequent weight gain, fewer hospital visits, and less narcotic use.
Topazian
Mark
M
Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55906, USA. topazian.mark@mayo.edu
Aslanian
Harry
H
Andersen
Dana
D
D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology* / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome