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Outcome Following Endoscopic Stenting of Pancreatic Duct Strictures in Chronic Pancreatitis

Topazian, Mark MD*; Aslanian, Harry MD; Andersen, Dana MD

Journal of Clinical Gastroenterology: November-December 2005 - Volume 39 - Issue 10 - p 908-911
doi: 10.1097/01.mcg.0000180799.18834.99
Liver, Pancreas, and Biliary Tract: Clinical Research
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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.

From the *Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN; †Division of Digestive Diseases, Yale University School of Medicine, New Haven, CT; and ‡Department of Surgery, University of Massachusetts Medical Center, Worcester, MA.

Received for publication February 22, 2005; accepted May 16, 2005.

Reprints: Mark Topazian, MD, Mayo Clinic, 200 First St. SW, Rochester, MN 55906 (e-mail: topazian.mark@mayo.edu).

© 2005 Lippincott Williams & Wilkins, Inc.