Clinical response to dorsal duct drainage via the minor papilla in refractory obstructing chronic calcific pancreatitis.

Abstract:

:Background and study aims Complete stone removal from the main pancreatic duct might not be achieved in all patients with obstructive chronic calcific pancreatitis. We report our results for endoscopic dorsal pancreatic duct (DPD) bypass of obstructing stones in the ventral pancreatic duct (VPD). Patients and methods 16 patients with obstructive chronic calcific pancreatitis were treated with a DPD bypass. Clinical success was defined as significant pain relief and no hospital admissions for pain management during the ongoing treatment period. Results Among 16 patients meeting entry criteria, 10 (62.5 %) had a history of unsuccessful endoscopic therapy, and 8 had failed extracorporeal shockwave lithotripsy (ESWL). Clinical success was achieved in 12 patients (75 %). Among these responders, 10 patients (83.3 %) had markedly improved or complete pain relief after the first stent placement, which persisted throughout the follow-up period; 11 patients (91.7 %) were able to discontinue their daily analgesics. Conclusions In selected patients with obstructive chronic calcific pancreatitis, the DPD bypass may be considered as a rescue endoscopic therapy, potentially obviating the need for surgery when standard endoscopic methods and ESWL fail.

journal_name

Endoscopy

journal_title

Endoscopy

authors

Kwon CI,Gromski MA,Sherman S,El Hajj II,Easler JJ,Watkins J,McHenry L,Lehman GA,Fogel EL

doi

10.1055/s-0042-120996

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

371-377

issue

4

eissn

0013-726X

issn

1438-8812

journal_volume

49

pub_type

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