Endoscopic stenting for pain relief in chronic pancreatitis: Results of a standardized protocol

Ponchon, Thierry; Bory, R; Hedelius, Franck; Roubein, Leor D.; Paliard, P; Napoléon, Bertrand; Chavaillon, Annick

doi:10.1016/s0016-5107(95)70049-8

Cited by 240 publications

(118 citation statements)

References 18 publications

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“…In two randomized controlled trials, long-term results of endoscopic treatment of pain compared to derivative surgery are conflicting [36,174]. Endoscopic therapy can be successfully repeated in case of pain relapses [175,176]. The spontaneous burn-out of pain in the natural history of chronic pancreatitis may interfere in the assessment of efficacy of endoscopic therapy [177].…”

Section: E2mentioning

confidence: 99%

“…Currently there are two strategies in pancreatic stenting: either removing the pancreatic stent after a period of 6−12 months irrespective of the resolution of the stricture of the main pancreatic duct or substitution of pancreatic stents until stricture disappearance [175,176,[193][194][195][196][197][198][199][200]. Long-term pain relief was experienced by two-thirds of patients after 12 months stenting, though resolution of the stricture was observed in a minority of patients [176,193]. Calibration of a single distal main pancreatic duct stricture with multiple stents insertion (range 2−4 large-bore stents for 6 months) is a promising approach recently described [198].…”

Section: E3: Is Endoscopic Therapy Indicated In Chronic Pancreatitismentioning

confidence: 99%

See 1 more Smart Citation

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

165

112

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This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l

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Section: E2mentioning

confidence: 99%

Section: E3: Is Endoscopic Therapy Indicated In Chronic Pancreatitismentioning

confidence: 99%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

165

112

View full text Add to dashboard Cite

show abstract

“…In chronic pancreatitis patients with dominant stricture, pain relief was obtained in 52%-95% of cases over a follow-up ranging from 8 to 72 mo [1,[7][8][9][10][11][12][13][14][15][16][17][18][19] . Stenting was also associated with weight gain and fewer hospital visits.…”

Section: Chronic Pancreatitismentioning

confidence: 99%

Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

Alberto¹,

Testoni²

2007

WJG

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The role of endoscopic therapy in the management of pancreatic diseases is continuously evolving; at present most pathological conditions of the pancreas are successfully treated by endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasound (EUS), or both. Endoscopic placement of stents has played and still plays a major role in the treatment of chronic pancreatitis, pseudocysts, pancreas divisum, main pancreatic duct injuries, pancreatic fistulae, complications of acute pancreatitis, recurrent idiopathic pancreatitis, and in the prevention of post-ERCP pancreatitis. These stents are currently routinely placed to reduce intraductal hypertension, bypass obstructing stones, restore lumen patency in cases with dominant, symptomatic strictures, seal main pancreatic duct disruption, drain pseudocysts or fluid collections, treat symptomatic major or minor papilla sphincter stenosis, and prevent procedure-induced acute pancreatitis. The present review aims at updating and discussing techniques, indications, and results of endoscopic pancreatic duct stent placement in acute and chronic inflammatory diseases of the pancreas.

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“…Symptomatic improvement in terms of pain from chronic pancreatitis following this treatment is reported to occur in 74-94% of patients. [24][25][26] Stenting also is reported to be effective in facilitating removal of stones by ESWL.…”

Section: Treatment Of Chronic Pancreatitismentioning

confidence: 99%

New developments in diagnosis and non‐surgical treatment of chronic pancreatitis

Inui

Yoshino

Miyoshi

et al. 2013

J of Gastro and Hepatol

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Chronic pancreatitis is progressive and irreversible, leading to digestive and absorptive disorders by destruction of the exocrine pancreas and to diabetes mellitus by destruction of the endocrine pancreas. When complications such as pancreatolithiasis and pseudocyst occur, elevated pancreatic ductal pressure exacerbates pain and induces other complications, worsening the patient's general condition. Combined treatment with extracorporeal shock-wave lithotripsy and endoscopic lithotripsy is a useful, minimally invasive, firstline treatment approach that can preserve pancreatic exocrine function. Pancreatic duct stenosis elevates intraductal pressure and favor both pancreatolithiasis and pseudocyst formation, making effective treatment vitally important. Endoscopic treatment of benign pancreatic duct stenosis stenting frequently decreases pain in chronic pancreatitis. Importantly, stenosis of the main pancreatic duct increases risk of stone recurrence after treatment of pancreatolithiasis. Recently, good results were reported in treating pancreatic duct stricture with a fully covered self-expandable metallic stent, which shows promise for preventing stone recurrence after lithotripsy in patients with pancreatic stricture. Chronic pancreatitis has many complications including pancreatic carcinoma, pancreatic atrophy, and loss of exocrine and endocrine function, as well as frequent recurrence of stones after treatment of pancreatolithiasis. As early treatment of chronic pancreatitis is essential, the new concept of early chronic pancreatitis, including characteristics findings in endoscopic ultrasonograms, is presented.

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Endoscopic stenting for pain relief in chronic pancreatitis: Results of a standardized protocol

Cited by 240 publications

References 18 publications

Italian consensus guidelines for chronic pancreatitis

Italian consensus guidelines for chronic pancreatitis

Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

New developments in diagnosis and non‐surgical treatment of chronic pancreatitis

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