title: Role of endoscopic stenting for biliary strictures in chronic pancreatitis.
abstract: OBJECTIVE
  To review the published work concerning the role of biliary stenting for chronic pancreatitis-related strictures.
  
  
  METHODS
  A case study in which multiple plastic stents are used to manage a chronic pancreatitis biliary stricture is presented, and the published work reviewed.
  
  
  RESULTS
  There has been a gradual evolution in the endoscopic management of distal biliary strictures secondary to chronic pancreatitis. Most early series used single (usually 10 F) plastic stents for varying time periods. Long-term stricture resolution occurred in only approximately 25% of patients and stent-related complications were high if stent exchanges were not performed routinely every 3-4 months. Recent studies using multiple (≥ 3) 10 F stents placed sequentially every few months for approximately 12 months have resulted in resolution of biliary strictures in up to 90% of patients. In general, the use of both uncovered and partially covered self-expandable metal stents for biliary strictures due to chronic pancreatitis have been disappointing due to problems with epithelial hyperplasia involving the uncovered portions of the self-expandable metal stents resulting in late stent occlusion and other problems. Similarly, early published data does not at this stage support the routine use of fully covered self-expandable metal stents because of unacceptable stent-related complications.
  
  
  CONCLUSIONS
  Chronic pancreatitis-related biliary strictures should be managed initially with sequentially-placed multiple 10 F plastic stents for approximately 12 months.
authors.affiliation: Department of Gastroenterology and Hepatology, St George Hospital, Kogarah, New South Wales, Australia. picraig@tpg.com.au
authors.forename: Philip I
authors.initials: PI
authors.lastname: Craig
mesh_terms: D001649:Bile Duct Diseases / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003251:Constriction, Pathologic; D004108:Dilatation, Pathologic; D006801:Humans; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000150:complications*; D015607:Stents; D014057:Tomography, X-Ray Computed