Analysis of the effects of stent insertion and the factors related to stent retrieval in chronic pancreatitis accompanying main pancreatic duct obstruction.
OBJECTIVE
Obstruction of the main pancreatic duct (MPD) has been considered one of the major causes for pain in chronic pancreatitis (CP). In this study, we evaluated the efficacy of MPD stenting in painful CP, and tried to determine a guideline for stent removal.


METHODS
Sixteen patients with painful CP who underwent MPD stenting were included. Follow up ERCP was performed 3 months after stenting in all patients. Stents were removed in patients who achieved pain relief, complete stone clearance, and decreased MPD diameter after 3 months.


RESULTS
Before stenting, ERCP showed MPD stricture in 11 cases, MPD dilatation by stone in 1 case, concomitant stricture and stone in 4 cases. After stenting, complete pain relief was achieved in 13 patients (81.3%) and partial pain relief was achieved in 3 patient (18.7%). There was no patient whose pain was not relieved. Stents were removed in 7 patients who achieved pain relief, complete stone clearance, and decreased MPD diameter after 3 months. Decrease of MPD diameter was significantly greater in patient who could remove stent than those who could not (72.9% vs. 127.9% of initial MPD diameter, p=0.008).


CONCLUSIONS
If partial or full pain relief is achieved after MPD stenting and follow up ERCP after 3 months shows decreased MPD diameter compared to the initial one, stent removal might be considered.
Kim
Chang Hoon
CH
Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Bang
Seungmin
S
Song
Kyung Ho
KH
Park
Jeong Youp
JY
Jeon
Tae Joo
TJ
Hong
Sung Pil
SP
Chung
Jae Bock
JB
Park
Seung Woo
SW
Song
Si Young
SY