Removable
fully covered metal stent for Chronic Pancreatitis post Lateral pancreatic
jejunostomy New stent
18
Year old female patient, case of chronic pancreatitis underwent Lateral
pancraetico jejunostomy. Presented with recurrent abdominal pain and nausea 1
year later. MRCP showing PD stricture in the head and neck of pancreas.
MRCP
Patient under went ERCP and stenting with 5
french stent Patients pain reduced. After 3 months pain recurred. ERCP done
showed a blocked stent stent was replaced by 7french stent after 3 months pain
reurred
ERCP Stenting
Patient
was given Option of surgey which she refused young girl with already one big
scar then the new stent Removable Bumpy stent was planned.
Endoscopy.
2012 Sep;44(9):874-7. doi: 10.1055/s-0032-1309774. Epub 2012 Jul 23.
Fully covered self-expanding metal stents for
refractory pancreatic duct strictures in chronic pancreatitis. Giacino C,
Grandval P,
Laugier R.
Fully covered self-expanding metal
stents (FC-SEMSs), which can be removed from the bile duct, have recently been
used in the main pancreatic duct (MPD) in chronic pancreatitis. The aim of this
study was to investigate the feasibility, safety, and efficacy of FC-SEMSs in
painful chronic pancreatitis with refractory pancreatic strictures. The primary
endpoints were technical success and procedure-related morbidity. Secondary
endpoints were pain relief at the end of follow-up and resolution of the
dominant pancreatic stricture at endoscopic retrograde pancreatography. Over 5
months, 10 patients with painful chronic pancreatitis and refractory dominant
pancreatic duct strictures were treated with FC-SEMSs. All FC-SEMSs were
successfully released and removed, although two stents were embedded in the MPD
at their distal end and treated endoscopically without complications. Mild
abdominal pain was noted in three patients after stent release. During
treatment, pain relief was achieved in nine patients, but one continued to take
morphine, because of addiction. Cholestasis developed in two patients and was
treated endoscopically; no patient developed acute pancreatitis or pancreatic
sepsis. After stent removal, the diameter of the narrowest MPD stricture had
increased significantly from 3.5 mm to 5.8 mm. Patients were followed up for a
mean of 19.8 months: two patients who continued drinking alcohol presented with
mild acute pancreatitis; one patient developed further chronic pancreatic pain;
and one had a transient pain episode. At the end of the study, nine patients no
longer had chronic pain and no patients had required surgery. Endoscopic
treatment of refractory MPD stricture in chronic pancreatitis by placement of
an FC-SEMS appears feasible, safe, and potentially effective.
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