Outcomes after clearance of pancreatic stones with or without pancreatic stenting

Accession number;07A0177213
Title;Outcomes after clearance of pancreatic stones with or without pancreatic stenting
Author; SASAHIRA NAOKI (Univ. Tokyo, Tokyo, Jpn) TADA MINORU (Univ. Tokyo, Tokyo, Jpn) ISAYAMA HIROYUKI (Univ. Tokyo, Tokyo, Jpn) HIRANO KENJI (Univ. Tokyo, Tokyo, Jpn) NAKAI YOUSUKE (Univ. Tokyo, Tokyo, Jpn) YAMAMOTO NATSUYO (Univ. Tokyo, Tokyo, Jpn) TSUJINO TAKESHI (Univ. Tokyo, Tokyo, Jpn) TODA NOBUO (Univ. Tokyo, Tokyo, Jpn) KOMATSU YUTAKA (Univ. Tokyo, Tokyo, Jpn) YOSHIDA HARUHIKO (Univ. Tokyo, Tokyo, Jpn) KAWABE TAKAO (Univ. Tokyo, Tokyo, Jpn) OMATA MASAO (Univ. Tokyo, Tokyo, Jpn)
Journal Title;J Gastroenterol
Journal Code:Z0748A
ISSN:0944-1174
VOL.42;NO.1;PAGE.63-69(2007)
Figure&Table&Reference;
Pub. Country;Japan
Language;English
Abstract;Background. Extracorporeal shockwave lithotripsy (ESWL) and endoscopic lithotripsy are useful for the fragmentation and extraction of pancreatic stones. However, pancreatic stones often recur, for which an adequate strategy is needed. Treatment for stricture of the main pancreatic duct (MPD) with a pancreatic stent after clearance of pancreatic stones may reduce the recurrence of pancreatic symptoms and stones. Methods. Forty patients with chronic pancreatitis with MPD stones were treated with ESWL in combination with endoscopic stone extraction. After clearance of the stones, a pancreatic stent was inserted when a stricture of MPD was observed on pancreatography. The stent was exchanged every 3 months and removed after a total of 1 year. We examined episodes of recurrent pain and pancreatitis in patients with and without stenting, as well as the MPD diameter, during follow-up. Results. MPD stricture was seen in 27 patients, and a stent was successfully inserted in 24 of them. Pancreatic symptoms recurred in five patients (21%) in the stenting group and in three patients (23%) in the control group during a mean follow-up period of 1.5 and 1.2 years, respectively. The diameter of the MPD, before, just after, and 1 year after treatment, was 7.6, 5.4, and 5.8 mm, respectively. It was significantly decreased after 1 year of follow-up, as well as just after stent removal, compared with before treatment (P < 0.05). Conclusions. Additional stenting for MPD after extraction of pancreatic stones may reduce the risk of recurrence of pancreatic symptoms. (author abst.)
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