Outcome following endoscopic stenting of pancreatic duct strictures in chronic pancreatitis

Goals: To assess outcomes following 6 months of endoscopic stenting for dominant pancreatic duct strictures in painful chronic pancreatitis. Background: Pancreatic stent placement may improve pain in chronic pancreatitis. Long-term outcomes after a 6-month period of stenting are unknown. Study: We identified all patients with chronic pancreatitis who underwent stenting of a dominant pancreatic duct stricture at one hospital. Stents were left in place for 6 months. Changes in weight, hospital visits, and narcotic use were analyzed. Results: Mean follow-up for the 15 subjects was 36 months; 87% improved following stent placement, and 11 (73%) completed 6 months of stent therapy. Hospital visits per subject decreased from 3.6 in the year prior to stent placement to 0.1 in the year after stent removal (P < 0.01). Oral narcotic use decreased from 33 mg MS0₄/day in the month prior to stenting to 2 mg MSO₄/day in the 12 months after stent removal (P = 0.01). Mean weight change was -5 kg in the year prior to stenting and +3.2 kg in the year after stent insertion (P < 0.01); 36% required endoscopic reintervention during the follow-up period. Conclusions: Six months of stenting resulted in sustained clinical improvement in most patients with chronic pancreatitis and a dominant pancreatic duct stricture. Stenting was associated with subsequent weight gain, fewer hospital visits, and less narcotic use.