LONG-TERM RESULTS OF PANCREATIC STENTS IN CHRONIC-PANCREATITIS

Background: Pancreatic stenting is a new nonsurgical treatment for pat ients with chronic pancreatitis and pain. We studied the long-term saf ety and efficacy of pancreatic stenting. Methods: Between 1982 and 199 3, 51 patients with chronic pancreatitis and persistent pain with domi nant strictures in the pancreatic duct were treated with plastic pancr eatic stents. Results: Stent insertion was successful in 49 of the 51 patients. Early complications occurred in 9 of the 51 patients (18%). Patients were followed for a median of 34 months (range 6 to 128). Nin e of the 49 patients had no clinical improvement and stents were remov ed. Forty of the 49 patients (82%) had clinical improvement. Sixteen o f these 40 patients still had their stents in place. Stents were remov ed in 22 of the 40 patients with persistent beneficial response in all (median follow-up 28.5 months). The long-term effect of stenting coul d not be evaluated in the remaining 2 patients because they had a doub le bypass operation. Stent dysfunction occurred in 27 of the 49 patien ts (55%) and was successfully treated by exchanging the stent. Conclus ions: Pancreatic stenting was associated with minimal early complicati ons, but stent dysfunction remained a frequent late complication. Panc reatic drainage resulted in clinical improvement in 40 of the 49 patie nts (82%). Twenty-two of these 40 patients maintained the beneficial r esponse after stent removal (28.5 months).