Download PDF
Endoscopy 2001; 33(01): 39-45
DOI: 10.1055/s-2001-11187
Review

Therapeutic Pancreatic Endoscopy

R. A. Kozarek
1   Virginia Mason Medical Center, Seattle, Washington, USA
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Therapeutic endoscopy in pancreatitis has included biliary or pancreatic sphincterotomy, or both, for microlithiasis and sphincter dysfunction. Alternatively, endoscopic treatment has been used to treat ductal disruption, including external or internal fistulas (high amylase effusions, pancreatic ascites, pancreaticoenteric communications, or pseudocysts). Finally, endoscopy has been used to treat obstructive disease, including both stones and strictures. This article reviews the state of the art in this field over the past year. Unfortunately, this is an area in which the appropriate approaches are still poorly defined, and prospective studies randomly assigning patients to endoscopic treatment in comparison with medical or surgical therapy remain few and far between.



Publication History

Publication Date:
31 December 2001 (online)

© 2001. Thieme. All rights reserved.

Georg Thieme Verlag Stuttgart · New York

 

  • References

  • 1 Fan ST, Lai EC, Mok FP. et al. Early treatment of acute biliary pancreatitis by endoscopic papillotomy.. N Engl J Med 1993; 328: 228-232
    Google Scholar
  • 2 Fölsch UR, Nitsche R, Ludtke R. et al. Early ERCP and papillotomy compared with conservative treatment for acute biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis.. N Engl J Med 1997; 336: 237-242
    Google Scholar
  • 3 Neoptolemos JP, Carr-Locke DL, London NJ. Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones.. Lancet 1988; 2: 979-985
    Google Scholar
  • 4 Nowak A, Nowakowska-Dulawa E, Marek TA. Final results of the prospective, randomized, controlled study on endoscopic sphincterotomy versus conventional management in acute biliary pancreatitis.. Gastroenterology 1995; 108: A380
    Google Scholar
  • 5 Kozarek RA. Endoscopic therapy of complete and partial pancreatic duct disruptions.. Gastrointest Endosc Clin North Am 1998; 8: 39-53
    Google Scholar
  • 6 Kozarek RA, Ball TJ, Patterson DJ. Endoscopic pancreatic duct sphincterotomy: indications, technique, and analysis of results.. Gastrointest Endosc 1994; 4: 592-598
    Google Scholar
  • 7 Lehman GA, Sherman S. Diagnosis and therapy of pancreas divisum.. Gastrointest Endosc Clin North Am 1998; 8: 55-77
    Google Scholar
  • 8 Costamagna G, Gabbrielli A, Mutignani M. Extracorporeal shock wave lithotripsy of pancreatic stones in chronic pancreatitis: immediate and medium-term results.. Gastrointest Endosc 1997; 46: 231-236
    Google Scholar
  • 9 Howell DA, Elton E, Parsons WG. Endoscopic management of pseudocysts of the pancreas.. Gastrointest Endosc Clin North Am 1998; 8: 143-162
    Google Scholar
  • 10 Ponchon T, Bory RM, Hedelius F. Endoscopic stenting for pain relief in chronic pancreatitis: results of a standardized protocol.. Gastrointest Endosc 1995; 42: 452-456
    Google Scholar
  • 11 Smits ME, Rauws EA, van Gulik TM. Long-term results of endoscopic stenting and surgical drainage for biliary stricture due to chronic pancreatitis.. Br J Surg 1996; 83: 764-768
    Google Scholar
  • 12 Hsu RK, Draganov P, Leung JW. Therapeutic ERCP in the management of pancreatitis in children.. Gastrointest Endosc 2000; 51: 396-400
    Google Scholar
  • 13 Glaser T, Stienecker K. Ultrasound secretin test in patients with pancreas divisum: an aid in the diagnosis of papillary or dorsal duct stenosis.. Z Gastroenterol 1999; 37: 585-588
    Google Scholar
  • 14 Ertan A. Long-term results after endoscopic pancreatic stent placement without pancreatic papillotomy in acute recurrent pancreatitis due to pancreas divisum.. Gastrointest Endosc 2000; 52: 9-14
    Google Scholar
  • 15 Testoni PA, Caporuscio S, Bagnolo F, Lella F. Idiopathic recurrent pancreatitis: long-term results after ERCP, endoscopic sphincterotomy, or ursodeoxycholic acid treatment.. Am J Gastroenterol 2000; 95: 1702-1707
    Google Scholar
  • 16 Smith MT, Sherman S, Ikenberry SO. Alterations in pancreatic ductal morphology following polyethylene pancreatic stent therapy.. Gastrointest Endosc 1996; 44: 268-275
    Google Scholar
  • 17 Boerma D, Huibregtse K, Gulik TM. Long-term outcome of endoscopic stent placement for chronic pancreatitis associated with pancreas divisum.. Endoscopy 2000; 32: 452-456
    Google Scholar
  • 18 Wehrmann T, Schmitt T, Seifert H. Endoscopic botulinum toxin injection into the minor papilla for treatment of idiopathic recurrent pancreatitis in patients with pancreas divisum.. Gastrointest Endosc 1999; 5: 545-548
    Google Scholar
  • 19 Wehrmann T, Seifert H, Seipp M. Endoscopic injection of botulinum toxin for biliary sphincter of Oddi dysfunction.. Endoscopy 1998; 3: 702-707
    Google Scholar
  • 20 Costamagna G, Ingrosso M, Tringali A. Santorinicele and recurrent acute pancreatitis in pancreas divisum: diagnosis with dynamic secretin-stimulated magnetic resonance pancreatography and endoscopic treatment.. Gastrointest Endosc 2000; 52: 262-267
    Google Scholar
  • 21 Norton ID, Petersen BT. Interventional treatment of acute and chronic pancreatitis: endoscopic procedures.. Surg Clin North Am 1999; 79: 895-911
    Google Scholar
  • 22 Samavedy R, Sherman S, Lehman GA. Endoscopic therapy in anomalous pancreatobiliary duct junction.. Gastrointest Endosc 1999; 5: 623-627
    Google Scholar
  • 23 Guelrud M, Morera C, Rodriguez M. Normal and anomalous pancreaticobiliary union in children and adolescents.. Gastrointest Endosc 1999; 5: 189-193
    Google Scholar
  • 24 Guelrud M, Morera C, Rodriguez M. Sphincter of Oddi dysfunction in children with recurrent pancreatitis and anomalous pancreaticobiliary union: an etiologic concept.. Gastrointest Endosc 1999; 5: 194-199
    Google Scholar
  • 25 Wright BE, Kozarek RA, Traverso LW. Recurrent pancreatitis in Gardner variant familial polyposis: etiology, diagnostic approach, and interventional results.. Arch Surg 1999; 134: 311-315
    Google Scholar
  • 26 Sakorafas GH, Tsiotou AG. Etiology and pathogenesis of acute pancreatitis: current concepts.. J Clin Gastroenterol 2000; 3: 343-356
    Google Scholar
  • 27 Gumaste V. Prophylactic antibiotic therapy in management of acute pancreatitis.. J Clin Gastroenterol 2000; 31: 6-10
    Google Scholar
  • 28 Baron TH, Morgan DE. Acute necrotizing pancreatitis.. N Engl J Med 1999; 34: 1412-1417
    Google Scholar
  • 29 Mergener K, Baillie J. Endoscopic treatment for acute biliary pancreatitis: when and in whom.. Gastroenterol Clin North Am 1999; 28: 601-603
    Google Scholar
  • 30 Arendt T, Nizze H, Liebe S. Does bile of patients with acute gallstone pancreatitis cause pancreatic inflammatory lesions? A study of pancreatic toxicity of choledochal secretions collected at ERCP.. Gastrointest Endosc 1999; 5: 209-213
    Google Scholar
  • 31 Harris A, Chan AC, Torres-Viera C. Meta-analysis of antibiotic prophylaxis in endoscopic retrograde cholangiopancreatography (ERCP).. Endoscopy 1999; 31: 718-724
    Google Scholar
  • 32 Nordback IH, Saaristo R, Paajanen H. et al. Does early imipenem-cilastatin therapy effect on the need for surgery in acute necrotizing pancreatitis?. Gastroenterology 2000; 118: A1062
    Google Scholar
  • 33 Freeman ML. Procedure-specific outcomes, assessment for endoscopic retrograde cholangiopancreatography.. Gastrointest Endosc Clin North Am 1999; 9: 639-647
    Google Scholar
  • 34 Rabenstein T, Schneider HT, Bulling D. et al. Analysis of the risk factors associated with endoscopic sphincterotomy techniques: preliminary results of a prospective study, with emphasis on the reduced risk of acute pancreatitis with low-dose anticoagulation treatment.. Endoscopy 2000; 32: 10-19
    Google Scholar
  • 35 Aymerich RR, Prakash C, Aliperti G. Sphincter of Oddi manometry: is it necessary to measure both biliary and pancreatic sphincter pressures?. Gastrointest Endosc 2000; 52: 183-186
    Google Scholar
  • 36 Okolo PI, Pasricha PJ, Kalloo AN. What are the long-term results of endoscopic pancreatic sphincterotomy?. Gastrointest Endosc 2000; 52: 15-19
    Google Scholar
  • 37 Binmoeller KF, Seifert H, Walter A. et al. Transpapillary and transmural drainage of pancreatic pseudocysts.. Gastrointest Endosc 1995; 42: 219-224
    Google Scholar
  • 38 Howell DA, Dy RM, Gerstein WH. et al. Infected pancreatic pseudocysts with colonic fistula formation successfully managed by endoscopic drainage alone: report of two cases.. Am J Gastroenterol 2000; 95: 1821-1823
    Google Scholar
  • 39 Bracher GA, Manocha AP, DeBarto JR. et al. Endoscopic pancreatic duct stenting to treat pancreatic ascites.. Gastrointest Endosc 1999; 49: 710-705
    Google Scholar
  • 40 Adamek HE, Jakobs R, Buttmann A. et al. Long-term follow-up of patients with chronic pancreatitis and pancreatic stones treated with extracorporeal shock wave lithotripsy.. Gut 1999; 45: 402-405
    Google Scholar
  • 41 Howell DA, Dy RM, Hanson BL. et al. Endoscopic treatment of pancreatic duct stones using a 10 F pancreatoscope and electrohydraulic lithotripsy.. Gastrointest Endosc 1999; 5: 829-833
    Google Scholar
  • 42 Vitale GC, Reed DN Jr, Nguyen CT. et al. Endoscopic treatment of distal bile duct stricture from chronic pancreatitis.. Surg Endosc 2000; 14: 227-231
    Google Scholar
  • 43 van Laethem JL. Ki-ras oncogene mutations in chronic pancreatitis: which discriminating ability for malignant potential?. Ann N Y Acad Sci 1999; 88: 210-218
    Google Scholar
  • 44 DiMagno EP, Reber HA, Tempero MA. AGA technical review on the epidemiology, diagnosis, and treatment of pancreatic ductal adenocarcinoma.. Gastroenterology 1999; 117: 1464-1484
    Google Scholar
  • 45 Roder JD, Stein HJ, Böttcher KA. et al. Stented versus nonstented pancreaticojejunostomy after pancreatoduodenectomy: a prospective study.. Ann Surg 1999; 229: 41-48
    Google Scholar
  • 46 Tham TC, Lichtenstein DR, Vandervoort J. et al. Pancreatic duct stents for “obstructive type” pain in pancreatic malignancy.. Am Gastroenterol 2000; 95: 956-960
    Google Scholar
  • 47 Costamagna G, Gabbrielli A, Mutignani M. et al. Treatment of “obstructive” pain by endoscopic drainage in patients with pancreatic head carcinoma.. Gastrointest Endosc 1993; 39: 774-777
    Google Scholar