Weber A et al. (2007) Endoscopic stent therapy for patients with chronic pancreatitis – results from a prospective follow-up study. Pancreas 34: 287–294

Surgery provides pain relief in 40–60% patients with chronic pancreatitis, pancreatic duct strictures and pancreatic duct stones; however, severe complications can occur. Endoscopic stent placement has been recommended as an alternative treatment for this condition.

Weber et al. evaluated the long-term benefits of endoscopic retrograde pancreatography (ERP) and stenting of the pancreatic duct in 19 patients with chronic pancreatitis and intermittent or continuous pain, ductal stenosis (with or without stones) and dilatation of the pancreatic duct. The stent was extracted or replaced depending on the findings during follow-up control ERPs; follow-up interviews enabled relapse rates 1 and 2 years after stent extraction to be considered.

Endoscopic stent placement (mean duration 5.6 months) reduced pain in 17 of 19 patients: cannulation and stent insertion could not be achieved in 2 patients. Increases in pain relative to that experienced after the initial stenting were reported in only 3 of 17 patients interviewed 1 year after stent extraction and in only 2 of 13 patients interviewed 2 years after stent extraction (1 patient was not available to be interviewed).

The authors acknowledge that the small patient cohort limited the scope of their study; however, they conclude that endoscopic stenting is safe and effective for relieving recurrent abdominal pain caused by chronic pancreatitis. As pain symptoms recurred in approximately 30% of patients within 2 years it has yet to be determined whether this procedure is preferable to surgery in the long-term.