Endoscopy 2020; 52(S 01): S212-S213
DOI: 10.1055/s-0040-1704663
ESGE Days 2020 ePoster Podium presentations
Saturday, April 25, 2020 11:00 – 11:30 ERCP: Chronic pancreatitis ePoster Podium 2
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC PANCREATIC DUCT STENTING IN MANAGEMENT OF CHRONIC PANCREATITIS

S Budzinskiy
1   N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
2   Moscow University Hospital #31, Moscow, Russian Federation
,
S Shapovalianz
1   N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
2   Moscow University Hospital #31, Moscow, Russian Federation
,
E Fedorov
1   N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
2   Moscow University Hospital #31, Moscow, Russian Federation
,
M Zakharova
3   Vishnevsky National Мedical Research Center of Surgery, Moscow, Russian Federation
,
E Platonova
2   Moscow University Hospital #31, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims To determine the role of endoscopic treatment of chronic pancreatitis (CP), especially its duct complications (DC).

Methods Endoscopic procedures were performed in 133 cases of complicated CP from 1.01.1998 to 1.01.2017. Majority of patients were male (88 (66.2%)), female patients were treated in 45 (33.8%) cases. Mean age was 54.4±12.4 years. Obstructive lesions of main pancreatic duct (MPD) were identified in 65 (48.9%) patients, pancreatic strictures in 42, MPD-stones - in 8, combination of strictures and stones - in 15 cases, defects of MPD were found in 68 (51.1%) cases: pancreatic fistulas (PF) - in 52 patients and pancreatic pseudocysts (PC) in 16 patients.

It was supposed to perform a pancreatic duct stenting (PS) in 114 cases. In cases of PC without communication with MPD transmural stenting alone lead to regression of PC. On the contrary, connection between PC and MPD required a combined approach - transpapillary and transmural stenting.

Results PS was successful in 78 cases (68.4%). It was performed in 40 of 65 (61.5%) cases of MPD occlusion, in 34 of 52 (65.4%) cases of PF and in 4 of 5 (80%) - in cases of connection between MPD and PC.

Endoscopic interventions in cases of CP and its DC were final treatment in 75 (56.4%) cases (30 patients with obstruction of the MPD, 45 - with MPD defect).

4 (3%) cases of complications after endoscopic treatment included 2 cases of bleeding, 1 case of perforation, and 1 case of and acute pancreatitis. All of complications required only conservative treatment. There were no fatal outcomes in observation.

Conclusions Endoscopic treatment of CP and its DC was possible in 68.4%. Endoscopic methods were the final tool in treatment of 46.1% of obstructive MPD lesions and in 66.2% of cases with defects of MPD. Endoscopic treatment guarantees a low level of complications (3%).