title: A long-term controlled trial of endoscopic pancreatic stenting for treatment of main pancreatic duct stricture in chronic pancreatitis.
abstract: OBJECTIVE
  Endoscopic pancreatic stenting (EPS) has been used to treat main pancreatic duct (MPD) stricture in chronic pancreatitis (CP), with favourable reported results. However, most studies were retrospective and uncontrolled. We conducted a longterm prospective controlled study of EPS for treatment of MPD stricture in CP.
  
  
  METHODS
  Consecutive patients with CP were treated to remove pancreatic stones by extracorporeal shock-wave lithotripsy or endoscopic basket extraction. After treatment, 41 patients were enrolled in the study upon meeting the criteria of complete removal of stones, pain relief after the treatment, and dominant stricture of the MPD. Twenty patients chose EPS, while 22 control patients did not. We compared recurrence of pain and pancreatic function between groups for over 3 years of follow-up.
  
  
  RESULTS
  The mean follow-up period was 62.5 ± 20.9 months. Pain recurred in 15% of EPS patients (3/20) and in 50.0% of control patients (11/22), a significant difference (p<0.05). Progression of exocrine insufficiency in the EPS group was significantly slower than in the control group (p<0.05), while endocrine function showed no difference between groups.
  
  
  CONCLUSIONS
  EPS reduced pain recurrence and slowed down the progression of exocrine insufficiency in CP patients with MPD stricture.
authors.affiliation: Department of Medicine and Clinical Oncology, Chiba University, Chiba, Japan. seza@mue.biglobe.ne.jp
authors.forename: Katsushi
authors.initials: K
authors.lastname: Seza
authors.forename: Taketo
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tadenema
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Tawada
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Saisho
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic; D004724:Endoscopy; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010183:Pancreatic Ducts; D050500:Pancreatitis, Chronic / Q000628:therapy*; D011446:Prospective Studies; D015607:Stents