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A prospective study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures

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Background/Aims: Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pan-creatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety ofFCSEMSs in this patient group. Methods: This prospective single-center study included patients who underwent endoscopic retrograde pancreatography withFCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain scoreof >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreaticstrictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events. Results: Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The meanvisual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were as-ymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancre-atitis (2.8%) were the most common adverse events. Conclusions: FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractorymain pancreatic duct strictures.

Abstract

Background/Aims: Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pan-creatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety ofFCSEMSs in this patient group. Methods: This prospective single-center study included patients who underwent endoscopic retrograde pancreatography withFCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain scoreof >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreaticstrictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events. Results: Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The meanvisual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were as-ymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancre-atitis (2.8%) were the most common adverse events. Conclusions: FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractorymain pancreatic duct strictures.

참고문헌 (25)

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