Histologic Changes After Stenting of the Pancreatic Duct

Álvarez, Carlos; Robert, Marie E.; Sherman, Stuart; Reber, Howard A.

doi:10.1001/archsurg.1994.01420310097018

Cited by 23 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In many cases, the stents were clogged within 2–3 months 8,14–16 . In addition, it was suspected that clogging of the stent could cause stone formation or attacks of pancreatitis 8,18 . In our examination of plastic stenting, efficacy in preventing stone recurrence was not obtained 8 .…”

Section: Discussionmentioning

confidence: 84%

Short‐term Metal Stenting for Treatment of Main Pancreatic Duct Strictures Associated With Chronic Pancreatitis

Okushima

Yoshino

Inui

et al. 2005

Digestive Endoscopy

View full text Add to dashboard Cite

Background: Stricture of the main pancreatic duct associated with chronic pancreatitis is a cause of pain due to ductal high pressure and the formation of pancreatic stones, but there is no established non-surgical therapeutic procedure. We attemped a new method for treating this condition, called short-term metal stenting. Methods: In three patients who had experienced recurrent stones and pancreatitis attacks several times after extracorporeal shock wave lithotripsy, a self-expandable metal stent was placed into the pancreatic duct for 2-7 days. Results: Dilatation was successful in all cases. Over observation periods of 18-25 months (mean, 22 months) following stent withdrawal, no recurrence of stones or attacks of pancreatitis was observed. Conclusion: Short-term metal stenting is an effective procedure for dilating stricture of the main pancreatic duct. It is also promising as a method for preventing recurrence of stones or episodes of pancreatitis.Key words: chronic pancreatitis, extracorporeal shock wave lithotripsy, metal stent, pancreatic ductal stricture.

show abstract

Section: Discussionmentioning

confidence: 84%

Short‐term Metal Stenting for Treatment of Main Pancreatic Duct Strictures Associated With Chronic Pancreatitis

Okushima

Yoshino

Inui

et al. 2005

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

“…Occlusion rates do not differ for 7‐Fr and 5‐Fr stents. Stent placement can cause changes in pancreatic ducts and parenchyma similar to those seen in CP and persisting for several weeks in up to 80% of patients, while persistent changes are seen in one‐third 32,66–70 . Outward and inward stent migrations have been described in 7.5% and 5.2% of patients respectively 63 …”

Section: Complications Of Pancreatic Endotherapymentioning

confidence: 99%

“…Stent placement can cause changes in pancreatic ducts and parenchyma similar to those seen in CP and persisting for several weeks in up to 80% of patients, while persistent changes are seen in one-third. 32,[66][67][68][69][70] Outward and inward stent migrations have been described in 7.5% and 5.2% of patients respectively. 63 Questions arising from the above information include the clinical significance of pancreatic changes seen following stent placement, causes and effects of stent blockage, and whether or not stent placement interferes with future surgery.…”

Section: Complications Of Pancreatic Endotherapymentioning

confidence: 99%

Endotherapy for pain in chronic pancreatitis

Khanna

Tandon

2008

J of Gastro and Hepatol

View full text Add to dashboard Cite

Pain is the most distressing symptom of chronic pancreatitis. Although the pathogenesis of pain is still poorly understood, an increase in intraductal pressure may be the dominant factor. The management of pain can involve medical, endoscopic, neurolytic, and surgical therapies. Endotherapy includes pancreatic sphincterotomy, extraction of stones, placement of stent, and dilatation of strictures, sometimes preceded or followed by extracorporeal shock-wave lithotripsy. Several studies have now shown that endotherapy provides partial or complete relief of pancreatic pain in a majority of patients with an acceptable frequency of early and late complications. Endotherapy should now graduate from an experimental form of treatment to a realistic treatment option in patients with chronic or relapsing pain, particularly in the setting of calcific chronic pancreatitis.

show abstract

“…Bei endosonographischen Untersuchungen ließen sich in unmittelbarer Nachbarschaft zum Stent fokale Pankreasparenchymveränderungen aufzeigen, die bei Nachuntersuchung 30 Monate nach Stententfernung als fokale chronische Pankreatitis in der ehemaligen Stentregion imponierten (44). Histologisch ist die Stentregion im Vergleich zum restlichen Pankreas durch vermehrte Fibrosierung, ausgeprägte Atrophie exokriner Zellen und vermehrte Entzündungsreaktionen gekennzeichnet (40).…”

Section: Stentdislokationunclassified

Stenting bei chronischer Pankreatitis - Fehler und Limitationen

Schwarz

Isenmann²,

Beger³

2000

Z Gastroenterol

View full text Add to dashboard Cite

Endoscopic treatment of chronic pancreatitis using pancreatic duct stents was first described 15 years ago. Considering our own experience and the data of the literature we describe indications, contraindications, risks and limitations of the procedure and on the other hand its therapeutic effects. According to the actual experience an indication for pancreatic duct stenting can be seen in patients with a solitary prepapillary stenosis without stenosis of side branches or as success control for a planned surgical intervention. Contraindications are suspected malignancy, multiple pancreatic duct stenosis in the main duct or stenosis in small ducts and chronic calcifying pancreatitis with pancreatic duct stones. From 6/92 until 5/97 189 patients were operated for chronic pancreatitis in the Ulm University Hospital. Of these patients 35 (18.7%) were unsuccessfully treated preoperatively in other hospitals by pancreatic duct stent. Because of frequent complications like stent dislocation and stent occlusion repeated ERCPs (4.5/patient) and stent exchanges (3.7/patient) were performed. A therapeutical long-term benefit of pancreatic duct stenting is questionable, a definitive therapy can only be achieved in a small group of patients. However stent-induced changes of the pancreatic duct similar to chronic pancreatitis can be observed in up to 80% of all patients. Long-term observations of the reversibility of these stent-induced changes are missing, persisting chronic pancreatitis in the stented region is reported in animal models and in humans. The rates in the literature for stent dislocation and stent occlusion rate are 10-18% and 39-100% respectively. Induction of acute pancreatitis (up to 10%), duodenal reflux into the pancreatic duct, and bacterial infection with abscess formation are further severe and frequent complications of pancreatic duct stenting (1, 2). Lethal courses are reported (3, 4). Endoscopic pancreatic duct stenting in chronic pancreatitis at present is not indicated because of low success rate and a substantial risk of complications.

show abstract

Histologic Changes After Stenting of the Pancreatic Duct

Cited by 23 publications

References 15 publications

Short‐term Metal Stenting for Treatment of Main Pancreatic Duct Strictures Associated With Chronic Pancreatitis

Short‐term Metal Stenting for Treatment of Main Pancreatic Duct Strictures Associated With Chronic Pancreatitis

Endotherapy for pain in chronic pancreatitis

Stenting bei chronischer Pankreatitis - Fehler und Limitationen

Contact Info

Product

Resources

About