Document Detail


Long-term results of endoscopic drainage of common bile duct strictures in chronic pancreatitis.
MedLine Citation:
PMID:  15647649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Endoscopic stent therapy is an established treatment modality for postoperative biliary strictures. At present, biliary stenting is also widely applied in chronic pancreatitis (CP), but results regarding long-term outcome are scarce. METHODS: All CP patients who underwent endoscopic biliary drainage of a benign stricture in our hospital between 1987 and 2000 were included in this retrospective study. RESULTS: Fifty-eight CP patients underwent biliary stenting (median age, 54 years; 44 male). The procedure-related mortality rate was 2% and the complication rate 4%. Median follow-up was 45 months (range, 0-182 months). Endoscopic treatment was successful in 22 patients (38%). Concomitant acute pancreatitis was the only factor identified as predictive of a successful outcome by multivariate analyses. Subanalysis of these 12 patients revealed a success rate of 92%, as opposed to 24% in cases without acute inflammation. In this latter group, continued stenting beyond a 1-year period almost never resulted in additional stricture resolvement. If stricture resolution was accomplished, however, no recurrences were observed. CONCLUSIONS: For biliary strictures due to CP, without evidence of concomitant acute pancreatitis, the long-term success rate of endoscopic therapy is poor and only one out of four strictures is treated successfully. When a biliary stricture has not resolved after 1 year of endoscopic stenting, surgery should be considered.
Authors:
Djuna L Cahen; Anne-Marie M van Berkel; Daphne Oskam; Erik A J Rauws; Gerrit Jan Weverling; Kees Huibregtse; Marco J Bruno
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  17     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-13     Completed Date:  2005-04-12     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  103-8     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands. D.L.Cahen@AMC.UVA.NL
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde*
Chronic Disease
Common Bile Duct Diseases / etiology,  surgery*
Constriction, Pathologic / etiology,  surgery
Drainage / methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pancreatitis / complications*
Prognosis
Retrospective Studies
Stents
Treatment Failure
Treatment Outcome

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


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