The Role of Endoscopy in Acute Recurrent and Chronic Pancreatitis and Pancreatic Cancer

Jakobs, Ralf; Riemann, J. F.

doi:10.1016/s0889-8553(05)70087-x

Cited by 21 publications

(7 citation statements)

References 63 publications

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“…Common bile duct stenoses caused by chronic pancreatitis represent a difficult clinical challenge for gastroenterologists and surgeons. Approximately 15-30 % of patients with chronic pancreatitis will develop such stenoses, which can result in cholestasis, cholangitis, jaundice and secondary biliary cirrhosis [1]. Biliary drainage procedures are indicated for symptomatic patients to prevent these considerable complications [2,3].…”

Section: Introductionmentioning

confidence: 99%

Self-expandable Metal Mesh Stents for Common Bile Duct Stenosis in Chronic Pancreatitis: Retrospective Evaluation of Long-term Follow-up and Clinical Outcome of a Pilot Study

Eickhoff

Jakobs²,

Leonhardt³

et al. 2003

Z Gastroenterol

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Self-expandable metal stents could be useful and adequate in patients who suffer from symptomatic obstructive jaundice due to chronic pancreatitis. However, they provide acceptable dilation of the common bile duct for only a limited period of time. Overall, endoscopic stenting with self-expandable metal stents seems to be an advantageous treatment only for a subgroup of patients who are unfavorable candidates for surgical drainage. To clarify the role of the endoscopic approach, prospective trials with homogeneous and larger patient numbers are necessarily in the future.

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Section: Introductionmentioning

confidence: 99%

Self-expandable Metal Mesh Stents for Common Bile Duct Stenosis in Chronic Pancreatitis: Retrospective Evaluation of Long-term Follow-up and Clinical Outcome of a Pilot Study

Eickhoff

Jakobs²,

Leonhardt³

et al. 2003

Z Gastroenterol

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“…With regard to interventions, ERCP has become an accepted modality for the treatment of pancreatic duct stones and strictures [5][6][7][8][9][10]. It is usually combined with sphincterotomy of either the minor or the major papilla, stent placement, or stone retrieval via basket or balloon catheter dilation.…”

Section: Discussionmentioning

confidence: 99%

“…In the case of isolated pancreatic strictures or strictures in the setting of accompanying pancreatic duct stones, several series have demonstrated symptom improvement in approximately Fig. 6 The outcomes of several studies demonstrating the efficacy of ESWL with respect to successful stone fragmentation, clearance, pain improvement, and mortality [5,[13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Complex Pancreatic Duct Stricture with Stone Versus Partial Pancreas Divisum—A Therapeutic Dilemma

2006

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Keywords Pancreatic duct stone . Pancreas divisum . Pancreatitis . Endoscopic retrograde cholangiopancreatography . Extracorporeal shock wave lithotripsy Pancreatic duct stone formation, characteristic of chronic pancreatitis, generally results in the obstruction of the outflow of pancreatic secretions, with increasing ductal pressure resulting in pancreatic hypertension and ischemia/necrosis [1]. Pancreatic duct stone removal can be accomplished either endoscopically or surgically. Removing these pancreatic duct stones by Endoscopic retrograde cholangiopancreatography (ERCP) is attractive in that it has considerably less morbidity than pancreatic surgery [2]. Unfortunately, pancreatic duct stones are often accompanied by pre-existing strictures as well as stones embedding into the ductal walls. If stone removal is successful via ERCP, the procedure often requires concomitant stent placement within the pancreatic duct. Alternatively, extracorporeal shock wave lithotripsy (ESWL) combined with endoscopy has been shown in several series to be beneficial in patients with pancreatic duct stones associated with pancreatic duct strictures [2].

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“…Weitere relativ häufige Ursachen von benignen Gallengangsstenosen sind die chronische Pankreatitis [6], die Lebertransplantation (Anastomosenstenosen [5] und die so genannten ITBL (ischemic type biliary lesions) [7]) und Gallengangseinengungen im Rahmen entzündlicher Veränderungen, vor allem bei Choledocholithiasis und primär-sklerosierender Cholangitis [8].…”

Section: Endoskopische Therapie Von Benignen Gallengangsstenosenunclassified

Interventionelle Endoskopie bei benignen und malignen Gallengangsstenosen

Jakobs

Weickert²,

Hartmann³

et al. 2005

Z Gastroenterol

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During the past years several endoscopic and interventional techniques have been developed for the treatment of bile duct strictures and have had a strong impact on therapeutic regimens. Benign stenoses of the bile duct are mainly caused by cholecystectomy or liver resection or by inflammatory diseases. Insertion of an endoprosthesis insertion or balloon dilation is clinically successful in 60 to 90 % of these patients and will result in adequate opening of the stricture. To date, only bile duct stenosis in chronic pancreatitis are not improved satisfactorily by endoscopy. The insertion of an endoprosthesis is a cornerstone in the treatment of malignant obstructive jaundice in patients with cancer. Several comparative studies have demonstrated the advantages of self-expanding metal stents (SEMS) over plastic prostheses in terms of patency. A selective use of SEMS is mandatory, as the costs for SEMS are high and many patients with malignant jaundice will die with their first plastic prosthesis in situ without stent occlusion. In patients with hilar cholangiocarcinoma, the combination of photodynamic therapy and endoprosthesis insertion might result in a survival advantage. The use of bioabsorbable stent materials or coating of the stent with antiproliferative drugs will improve the treatment results in the future.

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The Role of Endoscopy in Acute Recurrent and Chronic Pancreatitis and Pancreatic Cancer

Cited by 21 publications

References 63 publications

Self-expandable Metal Mesh Stents for Common Bile Duct Stenosis in Chronic Pancreatitis: Retrospective Evaluation of Long-term Follow-up and Clinical Outcome of a Pilot Study

Self-expandable Metal Mesh Stents for Common Bile Duct Stenosis in Chronic Pancreatitis: Retrospective Evaluation of Long-term Follow-up and Clinical Outcome of a Pilot Study

Complex Pancreatic Duct Stricture with Stone Versus Partial Pancreas Divisum—A Therapeutic Dilemma

Interventionelle Endoskopie bei benignen und malignen Gallengangsstenosen

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