Document Detail

Long-term follow-up of endoscopic stenting in patients with chronic pancreatitis secondary to pancreas divisum.
MedLine Citation:
PMID:  17514389     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pancreas divisum is the most common anatomic variant of pancreatic development and may lead to pancreatitis. This study evaluated the efficacy of endoscopic stenting in patients with chronic pancreatitis due to pancreas divisum. METHODS: Between 1993 and 2005, 32 patients with chronic pancreatitis due to pancreas divisum were treated with endoscopic stenting. Each patient underwent an endoscopic retrograde cholangiopancreatography to confirm the diagnosis of pancreas divisum prior to endoscopic stenting. A survey was conducted by telephone conversation to evaluate pain intensity, symptom relief, hospital admissions, quality of life and pain medication usage, which was verified by a statewide narcotic electronic database. Eight of the 32 patients were unavailable for the interview and were not included in the analysis of the study. Results are expressed as mean +/- standard error of the mean (SEM). RESULTS: Twenty-four patients were followed up for a period of 59.6 months. The overall pain level average in the 24 patients decreased significantly from 8.9 +/- 0.4 pre-stenting to 3.9 +/- 0.7 post-stenting (P < 0.05) on a scale of 1 to 10. The number of hospital admissions per year in these patients decreased significantly from 7.3 +/- 2.1 pre-stenting to 2.1 +/- 0.4 post-stenting (P < 0.05). Pain medication usage reported by the patients found a decrease in 58% of patients, 21% remained the same, and 13% increased their usage. There was improvement in nausea (67%), vomiting (63%), and chronic pain (75%). Thirteen patients (55%) were treated endoscopically without requiring surgery and 11 (45%) patients required surgery after stenting. These 11 patients had surgery an average of 25 months post-stenting. The complication rate of post-procedural pancreatitis was 3.4%. No mortality was reported in this study. CONCLUSION: Endoscopic stenting of the pancreatic duct is a safe and effective first treatment for patients with pancreatitis secondary to pancreas divisum. Surgery, when performed for endoscopic stenting failure, is effective as an adjunctive treatment.
Gary C Vitale; Michael Vitale; David S Vitale; John C Binford; Ben Hill
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Publication Detail:
Type:  Journal Article     Date:  2007-05-19
Journal Detail:
Title:  Surgical endoscopy     Volume:  21     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-16     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2199-202     Citation Subset:  IM    
Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, USA.
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MeSH Terms
Aged, 80 and over
Analgesics / therapeutic use
Cholangiopancreatography, Endoscopic Retrograde*
Digestive System Surgical Procedures / statistics & numerical data
Follow-Up Studies
Gastrointestinal Diseases / etiology,  physiopathology
Hospitalization / statistics & numerical data
Middle Aged
Pain / drug therapy,  physiopathology
Pancreas / abnormalities*,  surgery
Pancreatitis, Chronic / complications,  etiology*,  physiopathology,  therapy*
Postoperative Complications / epidemiology
Quality of Life
Sphincterotomy, Endoscopic
Treatment Outcome
Reg. No./Substance:

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

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