S. Sherman et al., STENT-INDUCED PANCREATIC DUCTAL AND PARENCHYMAL CHANGES - CORRELATIONOF ENDOSCOPIC ULTRASOUND WITH ERCP, Gastrointestinal endoscopy, 44(3), 1996, pp. 276-282
Background: Polyethylene pancreatic duct stents induce morphologic cha
nges of the pancreatic duct in the majority of patients. This study wa
s undertaken to determine if parenchymal abnormalities are present in
patients undergoing short-term pancreatic duct stenting and to correla
te these findings with the pancreatogram obtained at stent removal. Me
thods: Twenty-five patients underwent pancreatic duct stenting and had
an endoscopic ultrasound evaluation of the pancreas at stent removal.
The pancreatograms were evaluated at stent removal for ductal irregul
arity, narrowing, and side branch changes. Endoscopic ultrasound was u
sed to assess for differences in the echo characteristics of the pancr
eatic parenchyma around the stent compared with the rest of the gland.
Results: Of the 16 patients evaluated by ERCP at stent removal, 9 (56
%) had 1 or more new ductographic changes. Endoscopic ultrasound ident
ified parenchymal changes in the stented region in 17 of 25 patients (
68%). Four patients who had parenchymal changes in the stented region
on endoscopic ultrasound at stent removal had a follow-up study at a m
ean time of 16 months. Two patients had (new) changes suggestive of fo
cal chronic pancreatitis in the stented region. Conclusion: Short-term
pancreatic duct stenting induced both ductal and parenchymal changes
in more than 50% of patients. Chronic pancreatitis may be a consequenc
e of pancreatic duct stenting.