Stent-induced pancreatic ductal and parenchymal changes: correlation of endoscopic ultrasound with ERCP

Sherman, Stuart; Hawes, Robert H.; Savides, Thomas J.; Gress, Frank G.; Ikenberry, Steven O.; Smith, Milton T.; Zaidi, Syed; Lehman, Glen A.

doi:10.1016/s0016-5107(96)70164-5

Cited by 125 publications

(58 citation statements)

References 11 publications

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“…One of the patients developed fever after NPD placement that could be successfully treated with antibiotics and another patient developed infection of the pelvic pseudocysts that required additional percutaneous drainage. Pancreatic duct stenting has been shown to induce both ductal and parenchymal changes in more than 35% of patients [37][38][39][40]. Although studies have suggested that, following stent removal, the majority of ductal changes improve with time, there have been reports that permanent parenchymal changes consistent with chronic pancreatitis may follow pancreatic duct stenting [38].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic management of pancreatic pseudocysts at atypical locations

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Endoscopic management of pancreatic pseudocysts at atypical locations

et al. 2009

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“…Ductal lesions after stenting (dilatation, irregularity, stenosis) have been reported in 21%-80% of cases [17] . These lesions are associated with endosonographic parenchymal signs in 68% of cases [18] . In fact, in more than half of the cases, stenting-ductal lesions will regress four mo after retrieval of the stent [17] .…”

Section: Wwwwjgnetcommentioning

confidence: 99%

Endoscopic treatment of chronic pancreatitis

Heyries¹,

Sahel²

2007

WJG

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Treatment of chronic pancreatitis has been exclusively surgical for a long time. Recently, endoscopic therapy has become widely used as a primary therapeutic option. Initially performed for drainage of pancreatic cysts and pseudocysts, endoscopic treatments were adapted to biliary and pancreatic ducts stenosis. Pancreatic sphincterotomy which allows access to pancreatic ducts was firstly reported. Secondly, endoscopic methods of stenting, dilatation, and stones extraction of the bile ducts were applied to pancreatic ducts. Nevertheless, n e w i m p r o v e m e n t s w e r e n e c e s s a r y : f a i l u r e s o f pancreatic stone extraction justified the development of extra-corporeal shock wave lithotripsy; dilatation of pancreatic stenosis was improved by forage with a new device; moreover endosonography allowed guidance for celiac block, gastro-cystostomy, duodeno-cystostomy and pancreatico-gastrostomy. Although endoscopic treatments are more and more frequently accepted, indications are still debated. METHODSEndoscopic treatment needs a team (operator, anaesthesiologist) aware with Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures. Specific material is necessary: good fluoroscopy with the possibility to magnify pictures, and a duodenoscope with a 4.2 channel allowing insertion of high calibre stent (10 Fr). Moreover, a wide variety of endoscopic ancillar y instruments is essential: metallic and hydrophilic guidewire, sphincterotomes, Dormia basket, balloon dilatators and bougie dilatators (5-11.5 Fr), but also very thin guide wire (0.025 inches), fine-tipped sphincterotomes, Soehendra extractors (cf infra) [1] . Impaction of stones in pancreatic ducts needs the use of extracorporeal shock wave lithotripsy before endoscopic stone extraction [2]

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“…Because of elevated risk for pancreatic cancer, tissue samples are needed before endotherapy [146]. In addition, MPD stents may produce ductal changes, including strictures or focal areas of chronic pancreatitis [147,148]. However, these changes may improve with time.…”

Section: Pancreatic Ductal Stricturesmentioning

confidence: 99%

Endoscopic Treatment of Pancreatic Diseases

Vladimirov¹,

Getzov²,

Ivanova³

2015

Endoscopy - Innovative Uses and Emerging Technologies

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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.

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Stent-induced pancreatic ductal and parenchymal changes: correlation of endoscopic ultrasound with ERCP

Cited by 125 publications

References 11 publications

Endoscopic management of pancreatic pseudocysts at atypical locations

Endoscopic management of pancreatic pseudocysts at atypical locations

Endoscopic treatment of chronic pancreatitis

Endoscopic Treatment of Pancreatic Diseases

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