Alterations in pancreatic ductal morphology following polyethylene pancreatic stent therapy☆,☆☆,★,★★,♢
Section snippets
MATERIALS and METHODS
We reviewed the sequential pancreatograms of patients who had undergone pancreatic stenting at baseline (prior to stenting), immediately after stent removal, and after a remote interval when a follow-up study had been performed for clinical indications. All ductographic abnormalities were recorded with emphasis on their location, type of change, and severity. Baseline pancreatograms were read according to Cambridge criteria10 and classified as normal or abnormal (equivocal changes were
Frequency, type, and location of stent-induced ductal changes
Of the 61 patients studied, 40 (65.6%) had a normal baseline prestenting pancreatogram and 21 (34.4%) had changes of chronic pancreatitis. Most patients with normal baseline pancreatograms had stents inserted either for therapy of pancreas divisum or prior to pre-cut biliary sphincterotomy.13 Forty-nine patients (80.3%) were found to have stent-induced changes at the time of stent removal (Table 1). Twelve (19.7%) had no changes from the baseline pancreatogram. Of the total stent-induced
DISCUSSION
The use of endoscopic therapy for pancreatic diseases has progressed at a slower pace than similar techniques in the biliary tree, primarily because of the concern for procedure-related complications.14 Controlled trials regarding the efficacy and safety of pancreatic duct stenting are limited, and at this point firm indications for endoscopic drainage of the pancreas have not been established.15 Pancreatic stents may be beneficial to facilitate drainage in patients whose symptoms are believed
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Cited by (0)
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From the Indiana University Medical Center, Division of Gastroenterology/Hepatology, Indianapolis, Indiana.
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Current address for Dr. Smith: Walter Reed Army Medical Center, Washington, D.C. Current address for Dr. Hawes: Medical University of South Carolina, Charleston, S.C.
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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
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Reprint requests: Glen A. Lehman, MD, Indiana University Medical Center, 550 North University Blvd., Suite 2300, Indianapolis, IN 46202.
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