Document Detail


Endoscopic pancreatic-stent placement and sphincterotomy for relief of pain in tropical pancreatitis: results of a 1-year follow-up.
MedLine Citation:
PMID:  17591476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tropical chronic pancreatitis frequently presents with intractable abdominal pain. Surgical treatment has its own morbidity and mortality, and long-term results may not be satisfactory. OBJECTIVE: To analyze the results of endoscopic pancreatic-stent placement and sphincterotomy for the pain of tropical pancreatitis. DESIGN: Retrospective review. SETTING: Tertiary-referral hospital. PATIENTS: Twenty-four patients with tropical pancreatitis with severe, persistent pain not responding to standard medical therapy over a period of 30 months beginning January 1998. INTERVENTIONS: Stent placement of the pancreatic duct, along with sphincterotomy. MAIN OUTCOME MEASUREMENTS: At least 80% global improvement in pain as reported by the patient during follow-up after the procedure. RESULTS: In the 19 evaluable patients, the intended procedure, pancreatic stent placement along with sphincterotomy, was successful in 14 (73.7%); 3 others had sphincterotomy alone. Over a follow-up period of 6 to 38 months, 12 of the 14 patients (85.7%) who underwent stent placement plus sphincterotomy and 2 of the 3 patients who had sphincterotomy alone responded. Twelve of these were completely free of pain, and the remaining 2 patients had mild infrequent pain that occurred once in 2 to 4 months, lasting a few hours at a time and never needing hospitalization. The only major complication was the development of pancreatic sepsis, which required stent removal in 1 patient. Eight patients were stent free at the end of 6 months, and, over a further follow-up of 6 to 20 months, the pattern of pain relief persisted in them. LIMITATIONS: The retrospective nature of the study, the limited numbers studied, and the lack of assessment of pain on a standard visual analog scale. CONCLUSIONS: Stent placement of the pancreatic duct with pancreatic sphincterotomy constitutes an important nonsurgical therapeutic option for the intractable pain of tropical pancreatitis.
Authors:
C Ganesh Pai; Jose Filipe Alvares
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  66     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-26     Completed Date:  2007-10-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  70-5     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Kasturba Medical College, Manipal, India.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / etiology*,  radiography,  surgery*
Adolescent
Adult
Child
Cholangiopancreatography, Endoscopic Retrograde
Developing Countries
Female
Follow-Up Studies
Humans
India
Male
Middle Aged
Pancreatitis, Chronic / complications*,  radiography,  surgery
Retrospective Studies
Sphincterotomy, Endoscopic*
Stents*
Time Factors
Treatment Outcome
Tropical Climate
Comments/Corrections
Comment In:
Gastrointest Endosc. 2007 Jul;66(1):76-8   [PMID:  17591477 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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