Pancreatic duct stones in chronic pancreatitis: Criteria for treatment intensity and success

Farnbacher, Michael; Schoen, Christoph; Rabenstein, Thomas; Benninger, J.; Hahn, Eckhart G.; Schneider, H. T.

doi:10.1016/s0016-5107(02)70433-1

Cited by 125 publications

(51 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The procedure can be repeated with no extra risk, unlike the morbidity and difficulty associated with repeat surgery. The results are comparable to surgery and failed endotherapy does not hinder subsequent surgery [5][6][7][8] . The endoscopic approach can also predict the response to surgical therapy [9] .…”

Section: Introductionmentioning

confidence: 59%

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: Introductionmentioning

confidence: 59%

Endotherapy in chronic pancreatitis

Tandan

Reddy²

2013

WJG

View full text Add to dashboard Cite

show abstract

“…In another study of 125 patients, ESWL was found to enhances endoscopic interventions for PD stones when the mechanical lithotripsy fails [11]. ESWL has its own limitations.…”

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

“…The MPD stones are often impacted and difficult to extract, but up to 50% of MPD stones can be removed effectively by standard techniques, including endoscopic sphincterotomy or stone retrieval with a balloon, basket, and/or forceps alone [90,101,[118][119][120]. Endoscopic stent placement, mechanical lithotripsy, intracorporeal lithotripsy with a pulse-dye laser, or electrohydraulic lithotripsy, are other possibilities [90,[121][122][123][124][125]. Adding ESWL increases clearance rates to 60%-90% [90].…”

Section: Pancreatic Duct Stonesmentioning

confidence: 99%

Endoscopic Treatment of Pancreatic Diseases

Vladimirov¹,

Getzov²,

Ivanova³

2015

Endoscopy - Innovative Uses and Emerging Technologies

View full text Add to dashboard Cite

Endoscopic therapy has been increasingly recognized as an effective method of treatment in selected patients with pancreatic diseases. Various endoscopic procedures, classical and modified, are used for the complex treatment of acute and chronic pancreatitis, as well as their complications. In pancreatic carcinoma, some endoscopic methods are applied mainly as palliative measures. There are still open questions regarding the placing and timing of various endoscopic procedures in the multidisciplinary management approach of pancreatic diseases.

show abstract

Pancreatic duct stones in chronic pancreatitis: Criteria for treatment intensity and success

Cited by 125 publications

References 21 publications

Endotherapy in chronic pancreatitis

Endotherapy in chronic pancreatitis

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

Endoscopic Treatment of Pancreatic Diseases

Contact Info

Product

Resources

About