Long-Term Outcome after Pancreatic Stenting in Severe Chronic Pancreatitis

Eleftheriadis, Nicholas; Dinu, F.; Delhaye, Marie; Moine, Olivier Le; Baize, Michel; Vandermeeren, Alain; Hookey, Lawrence; Devière, Jacques

doi:10.1055/s-2005-860988

Cited by 159 publications

(98 citation statements)

References 8 publications

(20 reference statements)

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“…Early removal of a pancreatic stent can be considered if it has no effect on pain. 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].…”

Section: E3: Is Endoscopic Therapy Indicated In Chronic Pancreatitismentioning

confidence: 99%

“…Insertion of a pancreatic stent is indicated in case of dominant main pancreatic duct stricture (prepapillary stricture with upstream dilation). Current strategy calls for unscheduled stent replacement when patients become symptomatic (abdominal pain) and pancreatic duct dilation is shown by abdominal ultrasound or MRCP [175,[193][194][195][196]. Early removal of a pancreatic stent can be considered if it has no effect on pain.…”

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

166

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: E3: Is Endoscopic Therapy Indicated In Chronic Pancreatitismentioning

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

166

112

View full text Add to dashboard Cite

show abstract

“…This procedure with ERCP allows putting in place the transpapillary endoprotesis as drainage. In addition, the transluminal stones removal and/or lithotripsy can be possible, if intraductal stones are present [60][61][62]. The surgical management has shown good results in the treatment of chronic pseudocysts, pancreatic duct dilatation with stenosis, and stones.…”

Section: Chronic Pseudocystsmentioning

confidence: 99%

Management of Pancreatic Cystic Lesions

Neri¹

2017

Challenges in Pancreatic Pathology

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Objectives: In the last several decades, the knowledge of the cystic neoplasms has enlarged and the management has changed. The wide adoption in the diagnostic procedures of routine and advanced imaging has become the cornerstone of the diagnosis.Methods: Pancreatic cystic tumors comprise neoplasms with a wide range of malignant potential. The most common include serous cystic neoplasm, mucinous cystic neoplasms (MCNs), intraductal papillary mucinous neoplasms (IPMNs), solid pseudopapillary neoplasms (SPPNs), and cystic pancreatic endocrine neoplasms (CPENs). Other cystic lesions are acute postnecrotic pseudocysts and chronic pseudocysts. Finally, the indeterminate cystic lesions have been presented. Results:The epidemiology, pathological features, imaging characteristics, clinical evolution, and therapeutic choices of the most frequent lesions as well as less frequent forms are described. This study can be completed with the presentation of some cases of cystic pancreatic neoplasms treated in our service. Conclusion:The improvement of imaging, endoscopic modalities, and cyst fluid studies allows now accurate and reliable diagnosis of pancreatic cystic lesions. Moreover, the enlarged knowledge of valuable pathological studies established the potential for malignant transformation of these lesions identifying higher-risk neoplasms. Finally, the management options should be based on the assessment of each type of cystic neoplasms and the distinction of pancreatic cystic neoplasms (PCNs) from other cystic lesions.

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“…It is important to note, however, that after stent removal the rate of recurrence of a main PD stricture is high. In fact, Eleftherladis et al [39] reported the stricture relapse rate after a 2 year follow up period was as high as 38%, with these patients require repeat stenting.…”

Section: Pancreatic Stricturesmentioning

confidence: 99%

“…Two years after intervention, they noted a similar decrease in the number of pain episodes per year. As such, it was concluded that [39] 100 70 69 70 Rosch et al [35] 1018 88 60 85 Eisendrath et al [104] 100 100 69 70 Layer et al [105] 66 NA 36 50 Cremer et al [106] 75 NR 37 94…”

Section: Pancreatic Stonesmentioning

confidence: 99%

Endoscopic management of chronic pancreatitis

Oza

Kahaleh²

2013

WJGE

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Chronic pancreatitis (CP) is a common gastrointestinal illness, which affects the quality of life with substantial morbidity and mortality. The management includes medical, endoscopic and surgical approaches with the need for interaction between various specialties, calling for a concerted multidisciplinary approach. However, at the time of this publication, guidelines to establish care of these patients are lacking. This review provides the reader with a comprehensive overview of the studies summarizing the various treatment options available, including medical, surgical and endoscopic options. In addition, technological advances such as endoscopic retrograde cholangiopancreatogrophy, endoscopic shock wave lithotripsy and endoscopic ultrasound can now be offered with reasonable success for pancreatic decompression, stricture dilatation with stent placement, stone fragmentation, pseudocyst drainage, and other endoscopic interventions such as celiac plexus block for pain relief. We emphasize the endoscopic options in this review, and attempt to extract the most up to date information from the current literature. The treatment of CP and its complications are discussed extensively. Complications such as biliary strictures. pancreatic pseudocysts, and chronic pain are common issues that arise as long-term complications of CP. These often require endoscopic or surgical management and possibly a combination of approaches, however choosing amongst the various therapeutic and palliative modalities while weighing the risks and benefits, makes the management of CP challenging. Treatment goals should be not just to control symptoms but also to prevent disease progression. Our aim in this paper is to advocate and emphasize an evidence based approach for the management of CP and associated long term complications.

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Long-Term Outcome after Pancreatic Stenting in Severe Chronic Pancreatitis

Abstract: 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.

Cited by 159 publications

References 8 publications

Italian consensus guidelines for chronic pancreatitis

Italian consensus guidelines for chronic pancreatitis

Management of Pancreatic Cystic Lesions

Endoscopic management of chronic pancreatitis

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