Endoscopic pancreatic-stent placement and sphincterotomy for relief of pain in tropical pancreatitis

results of a 1-year follow-up

C. Ganesh Pai, Jose Filipe Alvares

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Tropical chronic pancreatitis frequently presents with intractable abdominal pain. Surgical treatment has its own morbidity and mortality, and long-term results may not be satisfactory. Objective: To analyze the results of endoscopic pancreatic-stent placement and sphincterotomy for the pain of tropical pancreatitis. Design: Retrospective review. Setting: Tertiary-referral hospital. Patients: Twenty-four patients with tropical pancreatitis with severe, persistent pain not responding to standard medical therapy over a period of 30 months beginning January 1998. Interventions: Stent placement of the pancreatic duct, along with sphincterotomy. Main Outcome Measurements: At least 80% global improvement in pain as reported by the patient during follow-up after the procedure. Results: In the 19 evaluable patients, the intended procedure, pancreatic stent placement along with sphincterotomy, was successful in 14 (73.7%); 3 others had sphincterotomy alone. Over a follow-up period of 6 to 38 months, 12 of the 14 patients (85.7%) who underwent stent placement plus sphincterotomy and 2 of the 3 patients who had sphincterotomy alone responded. Twelve of these were completely free of pain, and the remaining 2 patients had mild infrequent pain that occurred once in 2 to 4 months, lasting a few hours at a time and never needing hospitalization. The only major complication was the development of pancreatic sepsis, which required stent removal in 1 patient. Eight patients were stent free at the end of 6 months, and, over a further follow-up of 6 to 20 months, the pattern of pain relief persisted in them. Limitations: The retrospective nature of the study, the limited numbers studied, and the lack of assessment of pain on a standard visual analog scale. Conclusions: Stent placement of the pancreatic duct with pancreatic sphincterotomy constitutes an important nonsurgical therapeutic option for the intractable pain of tropical pancreatitis.

Original languageEnglish
Pages (from-to)70-75
Number of pages6
JournalGastrointestinal Endoscopy
Volume66
Issue number1
DOIs
Publication statusPublished - 01-07-2007

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Pancreatitis
Stents
Pain
Intractable Pain
Pancreatic Ducts
Chronic Pancreatitis
Pain Measurement
Visual Analog Scale
Tertiary Care Centers
Abdominal Pain
Sepsis
Hospitalization
Therapeutics
Retrospective Studies
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

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title = "Endoscopic pancreatic-stent placement and sphincterotomy for relief of pain in tropical pancreatitis: results of a 1-year follow-up",
abstract = "Background: Tropical chronic pancreatitis frequently presents with intractable abdominal pain. Surgical treatment has its own morbidity and mortality, and long-term results may not be satisfactory. Objective: To analyze the results of endoscopic pancreatic-stent placement and sphincterotomy for the pain of tropical pancreatitis. Design: Retrospective review. Setting: Tertiary-referral hospital. Patients: Twenty-four patients with tropical pancreatitis with severe, persistent pain not responding to standard medical therapy over a period of 30 months beginning January 1998. Interventions: Stent placement of the pancreatic duct, along with sphincterotomy. Main Outcome Measurements: At least 80{\%} global improvement in pain as reported by the patient during follow-up after the procedure. Results: In the 19 evaluable patients, the intended procedure, pancreatic stent placement along with sphincterotomy, was successful in 14 (73.7{\%}); 3 others had sphincterotomy alone. Over a follow-up period of 6 to 38 months, 12 of the 14 patients (85.7{\%}) who underwent stent placement plus sphincterotomy and 2 of the 3 patients who had sphincterotomy alone responded. Twelve of these were completely free of pain, and the remaining 2 patients had mild infrequent pain that occurred once in 2 to 4 months, lasting a few hours at a time and never needing hospitalization. The only major complication was the development of pancreatic sepsis, which required stent removal in 1 patient. Eight patients were stent free at the end of 6 months, and, over a further follow-up of 6 to 20 months, the pattern of pain relief persisted in them. Limitations: The retrospective nature of the study, the limited numbers studied, and the lack of assessment of pain on a standard visual analog scale. Conclusions: Stent placement of the pancreatic duct with pancreatic sphincterotomy constitutes an important nonsurgical therapeutic option for the intractable pain of tropical pancreatitis.",
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Endoscopic pancreatic-stent placement and sphincterotomy for relief of pain in tropical pancreatitis : results of a 1-year follow-up. / Pai, C. Ganesh; Alvares, Jose Filipe.

In: Gastrointestinal Endoscopy, Vol. 66, No. 1, 01.07.2007, p. 70-75.

Research output: Contribution to journalArticle

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N2 - Background: Tropical chronic pancreatitis frequently presents with intractable abdominal pain. Surgical treatment has its own morbidity and mortality, and long-term results may not be satisfactory. Objective: To analyze the results of endoscopic pancreatic-stent placement and sphincterotomy for the pain of tropical pancreatitis. Design: Retrospective review. Setting: Tertiary-referral hospital. Patients: Twenty-four patients with tropical pancreatitis with severe, persistent pain not responding to standard medical therapy over a period of 30 months beginning January 1998. Interventions: Stent placement of the pancreatic duct, along with sphincterotomy. Main Outcome Measurements: At least 80% global improvement in pain as reported by the patient during follow-up after the procedure. Results: In the 19 evaluable patients, the intended procedure, pancreatic stent placement along with sphincterotomy, was successful in 14 (73.7%); 3 others had sphincterotomy alone. Over a follow-up period of 6 to 38 months, 12 of the 14 patients (85.7%) who underwent stent placement plus sphincterotomy and 2 of the 3 patients who had sphincterotomy alone responded. Twelve of these were completely free of pain, and the remaining 2 patients had mild infrequent pain that occurred once in 2 to 4 months, lasting a few hours at a time and never needing hospitalization. The only major complication was the development of pancreatic sepsis, which required stent removal in 1 patient. Eight patients were stent free at the end of 6 months, and, over a further follow-up of 6 to 20 months, the pattern of pain relief persisted in them. Limitations: The retrospective nature of the study, the limited numbers studied, and the lack of assessment of pain on a standard visual analog scale. Conclusions: Stent placement of the pancreatic duct with pancreatic sphincterotomy constitutes an important nonsurgical therapeutic option for the intractable pain of tropical pancreatitis.

AB - Background: Tropical chronic pancreatitis frequently presents with intractable abdominal pain. Surgical treatment has its own morbidity and mortality, and long-term results may not be satisfactory. Objective: To analyze the results of endoscopic pancreatic-stent placement and sphincterotomy for the pain of tropical pancreatitis. Design: Retrospective review. Setting: Tertiary-referral hospital. Patients: Twenty-four patients with tropical pancreatitis with severe, persistent pain not responding to standard medical therapy over a period of 30 months beginning January 1998. Interventions: Stent placement of the pancreatic duct, along with sphincterotomy. Main Outcome Measurements: At least 80% global improvement in pain as reported by the patient during follow-up after the procedure. Results: In the 19 evaluable patients, the intended procedure, pancreatic stent placement along with sphincterotomy, was successful in 14 (73.7%); 3 others had sphincterotomy alone. Over a follow-up period of 6 to 38 months, 12 of the 14 patients (85.7%) who underwent stent placement plus sphincterotomy and 2 of the 3 patients who had sphincterotomy alone responded. Twelve of these were completely free of pain, and the remaining 2 patients had mild infrequent pain that occurred once in 2 to 4 months, lasting a few hours at a time and never needing hospitalization. The only major complication was the development of pancreatic sepsis, which required stent removal in 1 patient. Eight patients were stent free at the end of 6 months, and, over a further follow-up of 6 to 20 months, the pattern of pain relief persisted in them. Limitations: The retrospective nature of the study, the limited numbers studied, and the lack of assessment of pain on a standard visual analog scale. Conclusions: Stent placement of the pancreatic duct with pancreatic sphincterotomy constitutes an important nonsurgical therapeutic option for the intractable pain of tropical pancreatitis.

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