Medium-term Results of Endoscopic Treatment of Common Bile Duct Strictures in Chronic Calcifying Pancreatitis With Increasing Numbers of Stents

Pozsár, J; Sahin, Péter; László, Ferenc; Forró, G; Topa, L

doi:10.1097/00004836-200402000-00007

Cited by 99 publications

(55 citation statements)

References 16 publications

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“…Morphological resolution of stenosis in long-term follow-up studies is obtained in no more than 10% of patients [205][206][207]. More aggressive endoscopic therapy, by placement of multiple plastic stents, can obtain stricture resolution in 44−90% of cases with a 13-48 months follow-up period after stent removal [208][209][210]. Although the role of self-expandable metal stents is well established for malignant obstruction, their use in benign strictures including chronic pancreatitis is less clear and controversial [211][212][213].…”

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

162

111

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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%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

162

111

View full text Add to dashboard Cite

show abstract

“…(40) Another study that focused on the insertion of multiple plastic biliary stents (7.5-to 10-Fr; 1-5 stents) increasingly in 29 patients at three-monthly intervals showed that after two years of stent placement, only 60% had stent-free recovery at a follow-up period of about one year. (41) …”

Section: Plastic Stentsmentioning

confidence: 99%

Current status of endotherapy for chronic pancreatitis

Kwek

Maydeo²

2014

smedj

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Chronic pancreatitis is associated with varied morphological complications, including intraductal stones, main pancreatic ductal strictures, distal biliary strictures and pseudocysts. Endoscopic therapy provides a less invasive alternative to surgery. In addition, extracorporeal shockwave lithotripsy improves the success rate of endoscopic clearance of intraductal stones. However, recent data from randomised trials have shown better long-term outcomes with surgical drainage for obstructive pancreatic ductal disease. In patients with distal biliary strictures, stent insertion leads to good immediate drainage, but after stent removal, recurrent narrowing is common. Endoscopic drainage of pancreatic pseudocysts has excellent outcome and should be accompanied by pancreatic ductal stenting when a ductal communication is evident. In those who remain symptomatic, endoscopic ultrasonography-guided coeliac plexus block may provide effective but short-term pain relief. In this review, we present the current evidence for the role of endotherapy in the management of patients with chronic pancreatitis.

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“…A Hungarian study evaluated 29 patients with common bile duct stricture due to chronic calcifying pancreatitis [75] . These patients received the maximum possible number of stents whenever the stents were changed (electively at 3 mo intervals or sooner if stent change was indicated).…”

Section: Chronic Pancreatitis Related Stricturesmentioning

confidence: 99%

Endoscopic therapy of benign biliary strictures

Judah¹,

Draganov

2007

WJG

100

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Benign biliary strictures are being increasingly treated with endoscopic techniques. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. Surgery has been the traditional treatment, but there is increasing desire for minimally invasive endoscopic therapy. At present, endoscopy has become the first line approach for the therapy of postliver transplant anastomotic strictures and distal (Bismuth Ⅰand Ⅱ) post-operative strictures. Strictures related to chronic pancreatitis have proven more difficult to treat, and endoscopic therapy is reserved for patients who are not surgical candidates. The preferred endoscopic approach is aggressive treatment with gradual dilation of the stricture and insertion of multiple plastic stents. The use of uncovered self expandable metal stents should be discouraged due to poor long-term results. Treatment with covered metal stents or bioabsorbable stents warrants further evaluation. This area of therapeutic endoscopy provides an ongoing opportunity for fresh research and innovation.

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Medium-term Results of Endoscopic Treatment of Common Bile Duct Strictures in Chronic Calcifying Pancreatitis With Increasing Numbers of Stents

Abstract: Most chronic calcifying pancreatitis patients with common bile duct strictures respond to the increasing numbers of endoscopic stents, and remain stent free for medium term periods. Less patients (30%) does not benefit of biliary stenting, who are candidates for surgery.

Cited by 99 publications

References 16 publications

Italian consensus guidelines for chronic pancreatitis

Italian consensus guidelines for chronic pancreatitis

Current status of endotherapy for chronic pancreatitis

Endoscopic therapy of benign biliary strictures

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