Endoscopy 2018; 50(04): S83
DOI: 10.1055/s-0038-1637273
ESGE Days 2018 oral presentations
21.04.2018 – ERCP 4: Advanced procedures (cholangioscopy, pancreas)
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC DILATION OF PANCREATIC DUCT STRICTURES IN CHRONIC PANCREATITIS WITH MULTIPLE PALSTIC STENTS: RESULTS IN 48 PATIENTS

V Bove
1   Catholic University of Rome, Digestive Endoscopy Unit, Rome, Italy
,
A Tringali
1   Catholic University of Rome, Digestive Endoscopy Unit, Rome, Italy
,
I Boškoski
1   Catholic University of Rome, Digestive Endoscopy Unit, Rome, Italy
,
R Landi
1   Catholic University of Rome, Digestive Endoscopy Unit, Rome, Italy
,
F Barbaro
1   Catholic University of Rome, Digestive Endoscopy Unit, Rome, Italy
,
P Familiari
1   Catholic University of Rome, Digestive Endoscopy Unit, Rome, Italy
,
V Perri
1   Catholic University of Rome, Digestive Endoscopy Unit, Rome, Italy
,
G Costamagna
1   Catholic University of Rome, Digestive Endoscopy Unit, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Main pancreatic duct (MPD) strictures located in the head of the pancreas often occur in the course of chronic pancreatitis (CP). Common management of these strictures is endoscopic placement of a single plastic stent. Insertion of multiple plastic stents (MPS) obtained, in a series of 19 patients, symptomatic MPD stricture resolution in 84% of the cases, after 3-year follow-up. The aim of this study was to evaluate the results of the MPS strategy in a larger series of CP patients.

Methods:

Forty-eight patients (34 men; mean age 44 years, range 5 – 86) with CP and a symptomatic dominant MPD stricture in the head of the pancreas, were evaluated. All the patients experienced pain resolution following MPD drainage with a single plastic stents. The MPD stricture was refractory to single plastic stent placement in all cases and patients underwent insertion of MPS according to the following protocol: balloon dilation of the stricture if necessary, insertion of the maximum number of plastic stents allowed by the stricture tightness and pancreatic duct diameter, stents removal after 6 months.

Results:

The median number of stents placed was 3 (range 2 – 5), 8.5 to 11.5 Fr in diameter and 3 to 7 cm in length. MPS were removed after a mean time of 6.7 months (range 2 – 18). Eight patients (16.6%) had persistence of the MPD stricture after MPS removal and underwent replacement of an increased number of stents; 3/8 patients had a dilation of the stricture after further multistent placement (overall success 89.5%). Following a mean follow–up of 9.5 years (range 0.3 – 15.5) 77.1% of patients were asymptomatic. Recurrence was reported in 11 patients (22.9%), after a mean time of 26.4 months (range 5 – 108). No major complications were recorded.

Conclusions:

Endoscopic dilation of CP-related dominant MPD strictures seems possible with the MPS technique. According to our experience MPS is highly effective even at long-term follow-up in the majority of patients.