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Long-term outcome after pancreatic stenting in severe chronic pancreatitis.

Abstract：

BACKGROUND AND STUDY AIMS:Although it has been proved that pancreatic stenting is effective in the symptomatic management of severe chronic pancreatitis, long-term outcomes after stent removal have not been fully evaluated. PATIENTS AND METHODS:A total of 100 patients (75 men, 25 women; median age 49) with severe chronic pancreatitis and pancreatic duct strictures were successfully treated for pancreatic pain using polyethylene pancreatic stents and were followed up for at least 1 year after stent removal. The stents were exchanged "on demand" (in cases of recurrence of pain) and a definitive stent removal was attempted on the basis of clinical and endoscopic findings. Clinical variables were retrospectively assessed as potential predictors of re-stenting. RESULTS:The etiology of the chronic pancreatitis was alcoholic (77 %), idiopathic (18 %), or hereditary (5 %). Patients were followed up for a median period of 69 months (range 14 - 163 months) after study entry, including a median period of 27 months (range 12 - 126 months) after stent removal. The median duration of pancreatic stenting before stent removal was 23 months (range 2 - 134 months). After attempted definitive stent removal, 30 patients (30 %) required re-stenting within the first year of follow-up, at a median time of 5.5 months after stent removal (range 1 - 12 months), while in 70 patients (70 %) pain control remained adequate during that period. By the end of the follow-up period a total of 38 patients had required re-stenting and four ultimately underwent pancreaticojejunostomy. Pancreas divisum was the only factor significantly associated with a higher risk of re-stenting (P = 0.002). CONCLUSIONS:The majority (70 %) of patients with severe chronic pancreatitis who respond to pancreatic stenting maintain this response after definitive stent removal. However, a significantly higher re-stenting rate was observed in patients with chronic pancreatitis and pancreas divisum.

journal_name

Endoscopy

journal_title

Endoscopy

authors

Eleftherladis N,Dinu F,Delhaye M,Le Moine O,Baize M,Vandermeeren A,Hookey L,Devière J

doi

10.1055/s-2005-860988

subject

Has Abstract

pub_date

2005-03-01 00:00:00

pages

223-30

issue

eissn

0013-726X

issn

1438-8812

journal_volume

pub_type

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Long-term outcome after pancreatic stenting in severe chronic pancreatitis.