Endoscopic Therapy In A Cohort Of Patients With Chronic Pancreatitis From A Portuguese Reference Center

Aims Chronic pancreatitis (CP) is defined by progressive inflammatory and fibrotic changes in the pancreas, resulting in permanent structural damage. When medical therapy fails, endoscopic therapies (ET) may be required. The aim of this study is to evaluate the ET of a cohort of patients with CP.

Methods Retrospective observational study of CP patients undergoing ET between January/2010-December/2017. Demographic characteristics, used techniques, results and complications were evaluated.

Results Of a cohort of 92 patients with CP, 37 (40.2 %) underwent ET and 13 (14.1 %) surgery. Regarding the former, male: 83.8 %), average age: 61.3 years. Alcoholic pancreatitis was the most common form of pancreatitis (81.1 %), followed by idiopathic (16.2 %) and autoimmune (2.7 %). 54.1 % (n = 20) had smoking habits and 56.8 % (n = 21) had diabetes mellitus. 13.5 % (n = 5) had chronic pain. 102 ET were performed (endoscopic retrograde cholangiopancreatography: n = 99, endoscopic ultrasound: n = 3). Number of sessions per patient: 1 (n = 9), 2 (n = 8), 3 (n = 8), 4 (n = 7), 5 (n = 5). Indications for ET: wirsung stricture (n = 45), common bile duct (CBD) stricture (n = 41), pancreatic stones (n = 18), bile duct stones (n = 6), mass/nodule (n = 2), pseudocysts (n = 2), bile duct obstruction (n = 2), infected walled-off necrosis with CBD obstruction (n = 1). Main ET procedures: placement of pancreatic (n = 52) and biliary (n = 45) plastic stents, biliary/pancreatic sphincterotomy (n = 26), stricture dilation (n = 18), stone extraction (n = 13), lithotripsy (n = 4; laser n = 2; electrohydraulic n = 1; mechanical with trapezoid basket n = 1), placement of biliary metallic stents (n = 5), transgastric cystotomy with pig-tail plastic stents (n = 2) or HotAxios stent placement with 2 necrosectomy sessions (n = 1). There were no complications. Of those submitted to ET, 16.2 % (n = 6) underwent surgery, 4 due to CBD stricture and 2 because of solid mass. There were 9 deaths during follow-up (24.3 %), 2 due to pancreatic cancer and 7 not related to CP.

Conclusions According to our study, ET showed good results and safety profile, preventing surgical approach in the majority of cases during follow-up.

Citation Martins Figueiredo L ¹, Alexandrino G¹, Rafael MA et al. eP346 ENDOSCOPIC THERAPY IN A COHORT OF PATIENTS WITH CHRONIC PANCREATITIS FROM A PORTUGUESE REFERENCE CENTER. Endoscopy 2021; 53: S210.

Publication History

Article published online:
19 March 2021