Outcome of pancreaticojejunostomy after previous endoscopic stenting in patients with chronic pancreatitis.

OBJECTIVE

To assess whether previous endoscopic stenting of the pancreatic duct influences the outcome of subsequent pancreaticojejunostomy in chronic pancreatitis.

DESIGN

Retrospective analysis.

SETTING

University hospital, the Netherlands.

PATIENTS

50 patients with chronic pancreatitis, 26 of whom had previously had stents inserted and 24 who had not.

INTERVENTIONS

A questionnaire was sent to each patient to evaluate long-term pain relief, readmissions during follow-up and subjective efficacy of the operation, and risk factors for recurrent pain were calculated.

MAIN OUTCOME MEASURES

Postoperative morbidity, pain relief and subjective efficacy.

RESULTS

Patients with stents were operated on later (after 60 months of symptoms) than those without (17 months). 5 (19%) and 2 (8%) patients developed complications. No patient died. Personal follow-up (median 27 months) was obtained in 41 of 44 available patients (93%). 36 patients (88%) felt that they had benefited from pancreaticojejunostomy. 13 of the 21 patients with stents (62%) and 11 of the 20 patients without stents (55%) reported pain at least monthly, but of these 24 patients 21 patients (88%) had less pain than preoperatively; 11 (22%) had pain daily. 13 patients were readmitted for a relapse of pancreatitis, 3 of whom required partial pancreatectomy. Previous endoscopic stenting of the pancreatic duct was not a risk factor for recurrent pain (p = 0.61).

CONCLUSION

Endoscopic stenting of the pancreatic duct may be done for patients with chronic pancreatitis without adverse effects on the outcome of subsequent pancreaticojejunostomy.