Alterations in pancreatic ductal morphology following polyethylene pancreatic stent therapy

M. T. Smith, Stuart Sherman, S. O. Ikenberry, R. H. Hawes, Glen Lehman

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Abstract

Background: Polyethylene stents placed in the main pancreatic duct induce morphologic alterations that may resemble chronic pancreatitis. Methods: We reviewed the sequential pancreatograms of stented patients who had long-term follow-up after stent removal. Results: Forty patients (66%) had a normal baseline pancreatogram, whereas 21 (34%) showed changes of chronic pancreatitis. In 49 of 61 patients (80.3%), one or more had new morphologic changes immediately after stent withdrawal graded as mild (69%), moderate (29%), or severe (2%). Changes included ductal irregularity (49%), narrowing (35.5%), and side branch change (15.5%). Sixteen of the 21 patients (76.1%) with an abnormal baseline pancreatogram had worsening of the baseline abnormality or additional changes while stented, whereas 33 of 40 (82.5%) with a normal baseline developed new morphologic changes. Correlation of stent-induced changes with stent size, length, patency at removal, and duration of stenting failed to show an association. Twenty-five patients with stent-induced changes had a follow-up pancreatogram at a mean of 192 days (10 to 740) after stent removal. There was complete resolution of the changes in 64%, partial resolution in 32%, and no improvement in 5%. Conclusion: Morphologic changes induced by polyethylene pancreatic duct stents occurred in 80% of patients. More than one third of these changes did not resolve during the follow-up period. Because of concern over stent-induced fibrosis, the use of pancreatic stents should remain largely experimental.

Original languageEnglish
Pages (from-to)268-275
Number of pages8
JournalGastrointestinal Endoscopy
Volume44
Issue number3
StatePublished - 1996

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Polyethylene
Stents
Therapeutics
Pancreatic Ducts
Chronic Pancreatitis
Fibrosis

ASJC Scopus subject areas

  • Gastroenterology

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Alterations in pancreatic ductal morphology following polyethylene pancreatic stent therapy. / Smith, M. T.; Sherman, Stuart; Ikenberry, S. O.; Hawes, R. H.; Lehman, Glen.

In: Gastrointestinal Endoscopy, Vol. 44, No. 3, 1996, p. 268-275.

Research output: Contribution to journalArticle

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AU - Sherman, Stuart

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AU - Hawes, R. H.

AU - Lehman, Glen

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N2 - Background: Polyethylene stents placed in the main pancreatic duct induce morphologic alterations that may resemble chronic pancreatitis. Methods: We reviewed the sequential pancreatograms of stented patients who had long-term follow-up after stent removal. Results: Forty patients (66%) had a normal baseline pancreatogram, whereas 21 (34%) showed changes of chronic pancreatitis. In 49 of 61 patients (80.3%), one or more had new morphologic changes immediately after stent withdrawal graded as mild (69%), moderate (29%), or severe (2%). Changes included ductal irregularity (49%), narrowing (35.5%), and side branch change (15.5%). Sixteen of the 21 patients (76.1%) with an abnormal baseline pancreatogram had worsening of the baseline abnormality or additional changes while stented, whereas 33 of 40 (82.5%) with a normal baseline developed new morphologic changes. Correlation of stent-induced changes with stent size, length, patency at removal, and duration of stenting failed to show an association. Twenty-five patients with stent-induced changes had a follow-up pancreatogram at a mean of 192 days (10 to 740) after stent removal. There was complete resolution of the changes in 64%, partial resolution in 32%, and no improvement in 5%. Conclusion: Morphologic changes induced by polyethylene pancreatic duct stents occurred in 80% of patients. More than one third of these changes did not resolve during the follow-up period. Because of concern over stent-induced fibrosis, the use of pancreatic stents should remain largely experimental.

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