Abstract
Aim Endoscopic pancreatic stenting for refractory pancreatic duct strictures associated with impacted pancreatic stones in chronic pancreatitis cases has yielded conflicting results. We retrospectively evaluated the efficacy of endoscopic treatment in chronic pancreatitis patients with pancreatic duct strictures. Methods Pancreatic sphincterotomy, dilatation procedures, pancreatic brush cytology, and pancreatic juice cytology were routinely performed, and malignant diseases were excluded. After gradual dilatation, a 10 Fr plastic pancreatic stent was inserted. The stents were replaced every 3 months and removed after the strictures were dilated. Statistical analyses were performed to determine the risk of main pancreatic duct restenosis. Results Endoscopic pancreatic stents were successfully placed in 41 of a total of 59 patients (69.5%). The median duration of pancreatic stenting was 276 days. Pain relief was obtained in 37 of 41 patients (90.2%). Seventeen patients (41.5%) had recurrence of main pancreatic duct stricture, and restenting was performed in 16 patients (average placement period 260 days). During the follow-up period, pancreatic cancer developed in three patients (5.1%). Multivariate analysis revealed that the presence of remnant stones after stenting treatment was significantly associated with a higher rate of main pancreatic duct restenosis (p = 0.03). Conclusion The use of 10 Fr S-type plastic pancreatic stents with routine exchange was effective for both short-term and long-term outcomes in chronic pancreatitis patients with benign pancreatic duct strictures and impacted pancreatic stones.
Highlights
Chronic pancreatitis is a progressive, irreversible inflammatory disease characterized by pain, which is the symptom that requires treatment in most cases [1]
We retrospectively evaluated the usefulness and long-term outcomes of chronic pancreatitis with main pancreatic duct (MPD) strictures and pancreatic stones
The success rates of endoscopic pancreatic stenting (EPS) placements have been reported to range from 85%–98% [4,5,6], which is higher than that observed in the present study (69.5%)
Summary
Chronic pancreatitis is a progressive, irreversible inflammatory disease characterized by pain, which is the symptom that requires treatment in most cases [1] This disease is thought to be caused by increased pressure within the pancreatic ductal system and/or pancreatic parenchyma, secondary to the outflow obstruction of the main pancreatic duct (MPD) [2]. We started and preferred to use a polyolefin elastomer material with double-bended type (S shape) [15,16,17], which was a more soft material and suitable at the main pancreatic duct. This is the first reason we only use Stype pancreatic stent in our Hospital
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have