Long-term Outcomes of Endoscopic vs Surgical Drainage of the Pancreatic Duct in Patients With Chronic Pancreatitis

Cahen, Djuna L.; Gouma, Dirk J.; Laramée, Philippe; Nio, Yung; Rauws, Erik A.; Boermeester, Marja A.; Busch, Olivier R.; Fockens, Paul; Kuipers, Ernst J.; Pereira, Stephen P.; Wonderling, David; Dijkgraaf, Marcel G. W.; Bruno, Marco J.

doi:10.1053/j.gastro.2011.07.049

Cited by 289 publications

(215 citation statements)

References 21 publications

Supporting

Mentioning

190

Contrasting

Unclassified

Order By: Relevance

“…Inability to lead a social life, worsening nutritional conditions because of inability to ingest food, etc., are grave concerns that often confront practicing physicians. These guidelines refer to various pharmacotherapies and also describe the application of endoscopic and surgical treatments [69][70][71]. The utility of an elemental diet (ED) in patients with chronic pancreatitis with pain has been demonstrated; therefore, ED is recommended in these guidelines.…”

Section: Pain Managementmentioning

confidence: 99%

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

et al. 2016

View full text Add to dashboard Cite

Chronic pancreatitis is considered to be an irreversible progressive chronic inflammatory disease. The etiology and pathology of chronic pancreatitis are complex; therefore, it is important to correctly understand the stage and pathology and provide appropriate treatment accordingly. The newly revised Clinical Practice Guidelines of Chronic Pancreatitis 2015 consist of four chapters, i.e., diagnosis, staging, treatment, and prognosis, and includes a total of 65 clinical questions. These guidelines have aimed at providing certain directions and clinically practical contents for the management of chronic pancreatitis, preferentially adopting clinically useful articles. These revised guidelines also refer to early chronic pancreatitis based on the Criteria for the Diagnosis of Chronic Pancreatitis 2009. They include such items as health insurance coverage of high-titer lipase preparations and extracorporeal shock wave lithotripsy, new antidiabetic drugs, and the definition of and treatment approach to pancreatic pseudocyst. The accuracy of these guidelines has been improved by examining and adopting new evidence obtained after the publication of the first edition.

show abstract

Section: Pain Managementmentioning

confidence: 99%

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Three Randomized control trials have compared endoscopic treatment vs surgical drainage procedures, in that shortterm incidence of complications, pain relief and length of hospital stay is equal to surgical group. In long term surgical arm demonstrated a better symptom control and less re-intervention rate [4][5][6]. Although surgical options have been found to have better long-term symptom control, when compared with endoscopic options [4][5][6], most centres offer endoscopic approaches initially for those who are suitable for it (few stones, located proximally, without strictures) Endoscopic balloon or basket retrieval is indicated in small, floating calculi which are <5 mm in size.…”

Section: Discussionmentioning

confidence: 99%

“…In long term surgical arm demonstrated a better symptom control and less re-intervention rate [4][5][6]. Although surgical options have been found to have better long-term symptom control, when compared with endoscopic options [4][5][6], most centres offer endoscopic approaches initially for those who are suitable for it (few stones, located proximally, without strictures) Endoscopic balloon or basket retrieval is indicated in small, floating calculi which are <5 mm in size. Adequate pancreatic sphincterotomy is helpful before extraction [7].…”

Section: Discussionmentioning

confidence: 99%

Impacted wire basket in the main pancreatic duct; How to Jailbreak

Kapr¹,

Aa²

2017

Gastroenterol Hepatol Endosc

View full text Add to dashboard Cite

“…In case of main pancreatic duct dilation, guidelines advice endoscopic treatment as a reasonable first option, because of the less invasive nature of this treatment [12]. A recent study showed that after 5-year follow-up, symptomatic patients with advanced chronic pancreatitis who underwent surgery as the initial treatment for pancreatic duct obstruction had more pain relief with fewer procedures, than patients who were treated endoscopically [20]. Moreover, almost half of the patients who were treated with endoscopy eventually underwent surgery.…”

Section: Discussionmentioning

confidence: 99%

A wide variation in diagnostic and therapeutic strategies in chronic pancreatitis: A Dutch national survey

et al. 2012

View full text Add to dashboard Cite

Context Optimal diagnostic and treatment modalities in chronic pancreatitis are controversial due to lack of evidence. Objective To evaluate current clinical practice, we conducted a survey with the primary objective to evaluate decisions regarding the diagnosis, management and screening in chronic pancreatitis. Design We developed a vignette survey. Setting We surveyed Dutch gastroenterologists, internists, gastrointestinal surgeons and an international expert panel. Results A total of 110 questionnaires (31% gastroenterologists, 39% internists and 20% gastrointestinal surgeons) were returned out of the 1,324 sent (response 8.3%). There was a wide variation in strategies regarding diagnosis, treatment and screening in chronic pancreatitis. As a diagnostic test, serum amylase is used frequently by internists, while gastroenterologists and experts often use fecal elastase. Most respondents preferred CT-scanning for diagnosis, while experts preferred transabdominal ultrasonography as an initial test. Respondents frequently use pancreatic enzymes for treatment of pain in chronic pancreatitis. The majority advised to perform an intervention (endoscopic or surgical) in case of morphological changes of the pancreatic duct. Conclusions The results of our survey identify important differences between physicians in diagnosis and management of chronic pancreatitis. This is often due to lack of evidence and consensus in literature. Certain wide-spread practices are in contrast with available evidence, and should be addressed by improved education and adherence to guidelines.

show abstract

Long-term Outcomes of Endoscopic vs Surgical Drainage of the Pancreatic Duct in Patients With Chronic Pancreatitis

Cited by 289 publications

References 21 publications

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

Impacted wire basket in the main pancreatic duct; How to Jailbreak

A wide variation in diagnostic and therapeutic strategies in chronic pancreatitis: A Dutch national survey

Contact Info

Product

Resources

About