ENDOSCOPIC PANCREATIC STENTING IN CHRONIC PANCREATITIS WITH DUCTAL DILATION PROXIMAL TO A STRICTURE: A SAFE and EFFECTIVE PROTOCOL

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Abstract

ABSTRACT

After removal of intraductal stones, a 10-Fr or 7-Fr pancreatic stent was placed in 16 patients with upstream ductal dilation proximal to a stricture of the main pancreatic duct. Stents were removed after a mean duration of 52.5 days. Nine patients underwent repeated stenting. About one year after removal of the initial stent, when the remaining upstream ductal dilation was found on follow-up pancreatograms, the next stent was replaced. Repeated stenting improved outflow of pancreatic juice more effectively than one-time stenting. Correlation between long-term pain relief without recurrence of intraductal stones and reduction of duct diameter was also shown. Stent occlusion was observed in 14 of 30 stents. Stent occlusion was frequently associated with recurrence of pancreatitis and intraductal stones, and was also associated with morphologic changes in the pancreatic ductal system. Although there were no significant differences between stent patency of the initial stents and that of the next stents, stent patency of 10-Fr stents was superior to that of 7-Fr stents. 10-Fr stents should be removed within 8 weeks and 7-Fr stents should be removed within 4 weeks for the prevention of stent occlusion. Repeated stenting with short-term stenting is therefore considered a safe and effective protocol of endoscopic pancreatic stenting.

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