Outcome following endoscopic stenting of pancreatic duct strictures in chronic pancreatitis

J Clin Gastroenterol. 2005 Nov-Dec;39(10):908-11. doi: 10.1097/01.mcg.0000180799.18834.99.

Abstract

Goals: 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.

Study: 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.

MeSH terms

  • Adult
  • Aged
  • Cholangiopancreatography, Endoscopic Retrograde* / adverse effects
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Ducts / pathology*
  • Pancreatic Ducts / surgery*
  • Pancreatitis, Chronic / complications
  • Pancreatitis, Chronic / diagnosis*
  • Pancreatitis, Chronic / pathology
  • Pancreatitis, Chronic / surgery*
  • Retrospective Studies
  • Stents* / adverse effects
  • Tomography, X-Ray Computed
  • Treatment Outcome