Endoscopic stent therapy for patients with chronic pancreatitis: results from a prospective follow-up study.
OBJECTIVE
Obstruction of the pancreatic duct is a common feature of chronic pancreatitis and often requires interventional therapy. The current prospective study investigated clinical success in 19 patients after initial endoscopic retrograde pancreaticography and relapse rates during a 2-year follow-up period.


METHODS
Seventeen of 19 patients with chronic pancreatitis (stage III according to the Cambridge classification) were treated by sphincterotomy and stent insertion. Endoscopic retrograde pancreaticography failed in 2 patients.


RESULTS
Strictures were cannulated, dilated, and stones were removed with a dormia basket in 13 of 17 patients. Extracorporeal shock wave lithotripsy was necessary in 5 patients. Polyethylene stents (7F-11.5F) were placed into the dilated pancreatic duct. Mean duration of internal pancreatic stenting was 5.6 months. Three of 17 patients had recurrence of pain during the first follow-up year after stent extraction; in the second follow-up year, another 2 patients had a relapse. Overall, patients' assessment of the stent therapy revealed complete satisfaction in 17 of 19 patients.


CONCLUSIONS
Endoscopic stent therapy is a safe, minimally invasive, and effective procedure in patients experiencing pain attacks during chronic pancreatitis associated with dilated pancreatic duct. According to our results, a relapse rate of approximately 30% can be expected within 2 years after stent extraction. These patients may be treated by repeated stent therapy.
Weber
Andreas
A
From the II. Medizinische Klinik and Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Germany.
Schneider
Jochen
J
Neu
Bruno
B
Meining
Alexander
A
Born
Peter
P
Schmid
Roland M
RM
Prinz
Christian
C
D004106:Dilatation; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain; D050500:Pancreatitis, Chronic / Q000601:surgery*; D018579:Patient Selection; D011446:Prospective Studies; D012008:Recurrence; D015607:Stents