Modified fully covered self-expandable metal stents with antimigration features for benign pancreatic-duct strictures in advanced chronic pancreatitis, with a focus on the safety profile and reducing migration

Moon, Sung–Hoon; Kim, Myung–Hwan; Park, Do Hyun; Song, Tae Joon; Eum, Junbum; Lee, Sang Soo; Seo, Dong Wan; Lee, Sung Koo

doi:10.1016/j.gie.2010.01.063

Cited by 146 publications

(116 citation statements)

References 24 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…The initially used CSEMS had the disadvantage of stent migration. Subsequently a new "bumpy stent" has been tried for MPD strictures in 32 patients [34,35] . The stent had antimigratory properties and its contours adapted to the MPD.…”

Section: Endoscopic Management Of Pancreatic Ductal Stricturesmentioning

confidence: 99%

Endotherapy in chronic pancreatitis

Tandan

Reddy²

2013

WJG

View full text Add to dashboard Cite

Chronic pancreatitis (CP) is a progressive disease with irreversible changes in the pancreas. Patients commonly present with pain and with exocrine or endocrine insufficiency. All therapeutic efforts in CP are directed towards relief of pain as well as the management of associated complications. Endoscopic therapy offers many advantages in patients with CP who present with ductal calculi, strictures, ductal leaks, pseudocyst or associated biliary strictures. Endotherapy offers a high rate of success with low morbidity in properly selected patients. The procedure can be repeated and failed endotherapy is not a hindrance to subsequent surgery. Endoscopic pancreatic sphincterotomy is helpful in patients with CP with minimal ductal changes while minor papilla sphincterotomy provides relief in patients with pancreas divisum and chronic pancreatitis. Extracorporeal shock wave lithotripsy is the standard of care in patients with large pancreatic ductal calculi. Long term follow up has shown pain relief in over 60% of patients. A transpapillary stent placed across the disruption provides relief in over 90% of patients with ductal leaks. strictures. CP associated benign biliary strictures (BBS) are best treated with multiple plastic stents, as the response to a single plastic stent is poor. Covered self expanding metal stents are increasingly being used in the management of BBS though further long term studies are needed. Pseudocysts are best drained endoscopically with a success rate of 80%-95% at most centers. Endosonography (EUS) has added to the therapeutic armamentarium in the management of patients with CP. Drainage of pseudcysts, cannulation of inaccessible pancreatic ducts and celiac ganglion block in patients with intractable pain are all performed using EUS. Endotherapy should be offered as the first line of therapy in properly selected patients with CP who have failed to respond to medical therapy and require intervention.© 2013 Baishideng. All rights reserved.Key words: Chronic pancreatitis; Endoscopic retrograde cholangiopancreatography; Pancreatic sphincterotomy; Extracorporeal shockwave lithotripsy; Endosonography Core tip: Chronic pancreatitis is a challenge to the therapeutic endoscopist. A patient with chronic pancreatitis can present with ductal calculi, leaks, pseudocysts, strictures, pancreatic malignancy or a biliary obstruction. Endoscopic therapy offers a high rate of success in properly selected patients. It offers many advantages over surgery, which for a long time was considered the gold standard in the treatment of chronic pancreatitis. This chapter deals with the management of chronic pancreatitis associated strictures, calculi, leaks and pseudocysts. The role of endosonography in management of pseudocysts, cannulation of inaccessible ducts and pain relief has also been discussed.Tandan M, Reddy DN. Endotherapy in chronic pancreatitis.

show abstract

Section: Endoscopic Management Of Pancreatic Ductal Stricturesmentioning

confidence: 99%

Endotherapy in chronic pancreatitis

Tandan

Reddy²

2013

WJG

View full text Add to dashboard Cite

show abstract

“…In 2010, the same authors published their experience using a modified, fully covered SEMS (Niti-S Pancreatic Stent [bumpy type]; Taewoong Medical, Seoul, South Korea) that had antimigration features. (32) In this study, no stent migration occurred in all 32 patients. Additionally, all stents were easily removed at three months and pancreatography showed resolution of duct strictures.…”

Section: Self-expandable Metallic Stentsmentioning

confidence: 54%

Current status of endotherapy for chronic pancreatitis

Kwek

Maydeo²

2014

smedj

View full text Add to dashboard Cite

Chronic pancreatitis is associated with varied morphological complications, including intraductal stones, main pancreatic ductal strictures, distal biliary strictures and pseudocysts. Endoscopic therapy provides a less invasive alternative to surgery. In addition, extracorporeal shockwave lithotripsy improves the success rate of endoscopic clearance of intraductal stones. However, recent data from randomised trials have shown better long-term outcomes with surgical drainage for obstructive pancreatic ductal disease. In patients with distal biliary strictures, stent insertion leads to good immediate drainage, but after stent removal, recurrent narrowing is common. Endoscopic drainage of pancreatic pseudocysts has excellent outcome and should be accompanied by pancreatic ductal stenting when a ductal communication is evident. In those who remain symptomatic, endoscopic ultrasonography-guided coeliac plexus block may provide effective but short-term pain relief. In this review, we present the current evidence for the role of endotherapy in the management of patients with chronic pancreatitis.

show abstract

“…We therefore believe that this short-term treatment will prove effective in preventing recurrence of pancreatolithiasis. Recently, Moon et al 29 reported good results using a self-expandable metallic stent for pancreatic stricture. When those authors inserted a fully covered metallic stent or performed temporary stenting for 3 months, pancreatic strictures resolved in patients with advanced chronic pancreatitis.…”

Section: Treatment Of Chronic Pancreatitismentioning

confidence: 99%

New developments in diagnosis and non‐surgical treatment of chronic pancreatitis

Inui

Yoshino

Miyoshi

et al. 2013

J of Gastro and Hepatol

View full text Add to dashboard Cite

Chronic pancreatitis is progressive and irreversible, leading to digestive and absorptive disorders by destruction of the exocrine pancreas and to diabetes mellitus by destruction of the endocrine pancreas. When complications such as pancreatolithiasis and pseudocyst occur, elevated pancreatic ductal pressure exacerbates pain and induces other complications, worsening the patient's general condition. Combined treatment with extracorporeal shock-wave lithotripsy and endoscopic lithotripsy is a useful, minimally invasive, firstline treatment approach that can preserve pancreatic exocrine function. Pancreatic duct stenosis elevates intraductal pressure and favor both pancreatolithiasis and pseudocyst formation, making effective treatment vitally important. Endoscopic treatment of benign pancreatic duct stenosis stenting frequently decreases pain in chronic pancreatitis. Importantly, stenosis of the main pancreatic duct increases risk of stone recurrence after treatment of pancreatolithiasis. Recently, good results were reported in treating pancreatic duct stricture with a fully covered self-expandable metallic stent, which shows promise for preventing stone recurrence after lithotripsy in patients with pancreatic stricture. Chronic pancreatitis has many complications including pancreatic carcinoma, pancreatic atrophy, and loss of exocrine and endocrine function, as well as frequent recurrence of stones after treatment of pancreatolithiasis. As early treatment of chronic pancreatitis is essential, the new concept of early chronic pancreatitis, including characteristics findings in endoscopic ultrasonograms, is presented.

show abstract

Modified fully covered self-expandable metal stents with antimigration features for benign pancreatic-duct strictures in advanced chronic pancreatitis, with a focus on the safety profile and reducing migration

Cited by 146 publications

References 24 publications

Endotherapy in chronic pancreatitis

Endotherapy in chronic pancreatitis

Current status of endotherapy for chronic pancreatitis

New developments in diagnosis and non‐surgical treatment of chronic pancreatitis

Contact Info

Product

Resources

About