SINGLE VERSUS MULTIPLE PANCREATIC STENTS IN CHRONIC PANCREATITIS: A RETROSPECTIVE COMPARATIVE STUDY

Aims:

Stent insertion has been shown to be effective regarding pain resolution in patients with chronic pancreatitis (CP) and ductal strictures. It is not known if there is a benefit from inserting more than one stents, parallel one to the other. The aim of this study was to evaluate the outcome of pain in patients with painful PC who underwent insertion of a single versus multiple stents.

Methods:

Consecutive patients presenting with painful CP having undergone initial stenting during a 8-year period were considered. Exclusion criteria were: pancreatic surgery, pancreatic pseudocyst, biliary stricture, acute pancreatitis, pregnant women, age< 18 years, and follow-up (FU) less than 6 months. A total of 284 patients between 1/04 – 12/12 were retrospectively identified. 199 patients were excluded and 85 were included. The primary end-points were (1) definitive stent removal rate and (2) improvement of the pain score at the end of FU.

Results:

The study population included: patients having undergone single or multiple stenting during FU (group A, n = 53) and patients having undergone exclusively multiple stenting (group B, n = 32). Median FU was 44 months (range 2 – 138) in group A and 42 months (range 7 – 143) in group B (NS). Total stent duration was comparable: 21 (group A) vs. 22 months (group B). Stent removal was obtained in 43/53 (81%) of patients in group A vs. 29/32 (90%) in groupe B (NS). The mean pain score at the end of FU for patients who completed endotherapy was 0 (0 – 7) in group A and 6 (0 – 31) in group B (NS). Complete pain relief was achieved at the end of FU in 69% patients (37/53) of group A and 50% (16/32) in group B (NS).

Conclusions:

In this retrospective, comparative study, no benefit was identified for the group of patients with painful CP who were exclusively treated with multiple stents during their FU.