The Impact of Pancreatic Endotherapy on Quality of Life in Chronic Pancreatitis

Samuel Han; Nicole Rueb; Melica Nikahd; Fernanda Pessorrusso; Sachin Wani; Steven A Edmundowicz; Anna Duloy; Hazem T Hammad; Raj J Shah

doi:10.1016/j.gie.2024.12.002

The Impact of Pancreatic Endotherapy on Quality of Life in Chronic Pancreatitis

Gastrointest Endosc. 2024 Dec 9:S0016-5107(24)03775-1. doi: 10.1016/j.gie.2024.12.002. Online ahead of print.

Authors

Samuel Han¹, Nicole Rueb², Melica Nikahd³, Fernanda Pessorrusso², Sachin Wani², Steven A Edmundowicz², Anna Duloy², Hazem T Hammad², Raj J Shah⁴

Affiliations

¹ Division of Gastroenterology and Hepatology Mayo Clinic, Rochester, Minnesota.
² Division of Gastroenterology and Hepatology University of Colorado Anschutz Medical Campus, Aurora, Colorado.
³ Center for Biostatistics The Ohio State University Wexner Medical Center, Columbus, Ohio.
⁴ Division of Gastroenterology and Hepatology University of Colorado Anschutz Medical Campus, Aurora, Colorado. Electronic address: [email protected].

PMID: 39662636
DOI: 10.1016/j.gie.2024.12.002

Abstract

Background and aims: Pancreatic endotherapy (PET) offers a treatment option for complications of chronic pancreatitis (CP) such as pancreatic duct (PD) strictures, stones, and pseudocysts. As prior studies have primarily focused on how PET affects pain, the primary aim of this study was to evaluate the effect of PET on quality of life.

Methods: This single-center prospective study assessed quality of life before the initiation of endotherapy utilizing a validated CP-specific quality of life instrument (PANQOLI). Quality of life, pain levels, and opiate use were also measured at 1-, 3-, 6-, and 12-months follow-up. PET modalities included therapeutic PD stent placement, PD stone lithotripsy, EUS-guided pseudocyst drainage, and celiac plexus block (EUS-CPB). A repeated measures mixed effects model was used to compare pre- and post-PET changes in quality of life at each follow-up point.

Results: A total of 120 subjects with CP (mean age of 52.3, 58.3% female) were included in this study. PET modalities consisted primarily of therapeutic PD stenting (49.2%), EUS-CPB (32.5%), and PD stone lithotripsy (16.7%). Significant improvements in quality of life scores were seen at 1, 3, 6, and 12 months post-PET completion with the greatest improvement seen at 6 months (mean increase of 15.5 points). Significant improvements in pain levels were seen at 1-and 6-month follow-up, but not at 12-month follow-up. Decrease in opiate use was seen at all follow-up points.

Conclusions: Pancreatic endotherapy is associated with improvement in quality of life up to 1-year post-treatment, however, pain improvement was seen only to 6 months post-treatment reflecting the complexity of pain management in this difficult patient population. Further studies are needed to predict responders to endotherapy.