Endoscopic versus Surgical Drainage of the Pancreatic Duct in Chronic Pancreatitis

Cahen, Djuna L.; Gouma, Dirk J.; Nio, Yung; Rauws, Erik A.; Boermeester, Marja A.; Busch, Olivier R.; Stoker, Jaap; Laméris, Johan S.; Dijkgraaf, Marcel G. W.; Huibregtse, K.; Bruno, Marco J.

doi:10.1056/nejmoa060610

Cited by 758 publications

(542 citation statements)

References 34 publications

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“…Dite et al [5] , in a prospective randomized trial comparing endoscopic and surgical therapy for chronic, painful, obstructive pancreatitis, reported complete resolution of pain at the five-year follow-up in 37% of patients after surgery and in 14% of those after endotherapy; short-term results were similar in the two groups. Similar data have been recently published by Cahen et al [6] .…”

Section: Chronic Pancreatitissupporting

confidence: 81%

Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

Alberto¹,

Testoni²

2007

WJG

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The role of endoscopic therapy in the management of pancreatic diseases is continuously evolving; at present most pathological conditions of the pancreas are successfully treated by endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasound (EUS), or both. Endoscopic placement of stents has played and still plays a major role in the treatment of chronic pancreatitis, pseudocysts, pancreas divisum, main pancreatic duct injuries, pancreatic fistulae, complications of acute pancreatitis, recurrent idiopathic pancreatitis, and in the prevention of post-ERCP pancreatitis. These stents are currently routinely placed to reduce intraductal hypertension, bypass obstructing stones, restore lumen patency in cases with dominant, symptomatic strictures, seal main pancreatic duct disruption, drain pseudocysts or fluid collections, treat symptomatic major or minor papilla sphincter stenosis, and prevent procedure-induced acute pancreatitis. The present review aims at updating and discussing techniques, indications, and results of endoscopic pancreatic duct stent placement in acute and chronic inflammatory diseases of the pancreas.

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Section: Chronic Pancreatitissupporting

confidence: 81%

Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

Alberto¹,

Testoni²

2007

WJG

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“…Endoscopic therapy is recommended in symptomatic patients with benign pancreatic obstruction due to chronic pancreatitis or post-surgical stenosis [240,311,312]. Retrograde pancreatic stenting is technically successful in 85 -98 % of cases, with immediate clinical respite seen in 65 -95 % but lower pain relief on follow-up only in 32 -68 %.…”

Section: Eus-guided Pancreatography/drainage Backgroundmentioning

confidence: 99%

“…Retrograde pancreatic stenting is technically successful in 85 -98 % of cases, with immediate clinical respite seen in 65 -95 % but lower pain relief on follow-up only in 32 -68 %. Stenting can be used as a bridging procedure prior to surgical intervention, as surgery is superior to endoscopic treatment [122,311,312]. When ERP fails or surgical intervention is not feasible, alternative techniques are required.…”

Section: Eus-guided Pancreatography/drainage Backgroundmentioning

confidence: 99%

Untitled

2016

Ultraschall in Med

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“…Few studies have compared endoscopic approaches with surgery. A recent randomized controlled Dutch trial compared endoscopic therapy with surgical drainage and suggested that surgical drainage was more effective in relieving obstruction and achieving pain relief [63]. However, most centres still attempt endoscopic therapy prior to surgery unless there is suspicion for pancreatic cancer possibly due to referral biases.…”

Section: Surgery Vs Endotherapymentioning

confidence: 99%

Surgery for Chronic Pancreatitis

Perwaiz¹,

Singh²,

Chaudhary³

2011

Indian J Surg

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Chronic pancreatitis (CP) is progressive inflammatory process of the pancreas. Abdominal pain remains the most debilitating symptom affecting quality of life, apart from diabetes mellitus, steatorrhoea and weight loss. The treatment options have evolved over the past decades and are aimed to provide durable relief in pain with possible attempt to support or improve the failing endocrine and exocrine functions. Surgical treatment options have shown the potentials to provide superior long term results compared to the pharmacological and endoscopic modalities and are broadly divided in to drainage, resection and combination hybrid procedures. The choice is based on the morphology of the main pancreatic duct, presence of head mass and associated complication of CP. Knowing the basic nature of the disease, total pancreatectomy seems a curative option but not without significant morbidities. There is recent paradigm shift towards organ sparing surgical procedures with reasonable success. Despite recent advancement in the treatment modalities for CP the overall quality of life remains moderate which need further addressal.

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Endoscopic versus Surgical Drainage of the Pancreatic Duct in Chronic Pancreatitis

Abstract: Surgical drainage of the pancreatic duct was more effective than endoscopic treatment in patients with obstruction of the pancreatic duct due to chronic pancreatitis. (Current Controlled Trials number, ISRCTN04572410 [controlled-trials.com].).

Cited by 758 publications

References 34 publications

Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

Endoscopic pancreatic duct stent placement for inflammatory pancreatic diseases

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Surgery for Chronic Pancreatitis

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