Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

Background and aims: Clarification of the position of the European Society of Gastrointestinal Endoscopy (ESGE) regarding the interventional options available for treating patients with chronic pancreatitis.

Methods: Systematic literature search to answer explicit key questions with levels of evidence serving to determine recommendation grades. The ESGE funded development of the Guideline.

Summary of selected recommendations

For treating painful uncomplicated chronic pancreatitis, the ESGE recommends extracorporeal shockwave lithotripsy/endoscopic retrograde cholangiopancreatography as the first-line interventional option. The clinical response should be evaluated at 6 – 8 weeks; if it appears unsatisfactory, the patient’s case should be discussed again in a multidisciplinary team. Surgical options should be considered, in particular in patients with a predicted poor outcome following endoscopic therapy (Recommendation grade B). For treating chronic pancreatitis associated with radiopaque stones ≥ 5 mm that obstruct the main pancreatic duct, the ESGE recommends extracorporeal shockwave lithotripsy as a first step, combined or not with endoscopic extraction of stone fragments depending on the expertise of the center (Recommendation grade B).

For treating chronic pancreatitis associated with a dominant stricture of the main pancreatic duct, the ESGE recommends inserting a single 10-Fr plastic stent, with stent exchange planned within 1 year (Recommendation grade C). In patients with ductal strictures persisting after 12 months of single plastic stenting, the ESGE recommends that available options (e. g., endoscopic placement of multiple pancreatic stents, surgery) be discussed in a multidisciplinary team (Recommendation grade D).

For treating uncomplicated chronic pancreatic pseudocysts that are within endoscopic reach, the ESGE recommends endoscopic drainage as a first-line therapy (Recommendation grade A).

For treating chronic pancreatitis-related biliary strictures, the choice between endoscopic and surgical therapy should rely on local expertise, patient co-morbidities and expected patient compliance with repeat endoscopic procedures (Recommendation grade D). If endoscopy is elected, the ESGE recommends temporary placement of multiple, side-by-side, plastic biliary stents (Recommendation grade A).

• References

• 1 Rösch T, Daniel S, Scholz M et al. Endoscopic treatment of chronic pancreatitis: a multicenter study of 1000 patients with long-term follow-up. Endoscopy 2002; 34: 765-771
• 2 Boustière C, Veitch A, Vanbiervliet G et al. Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2011; 43: 445-461
• 3 Sica GT, Braver J, Cooney MJ et al. Comparison of endoscopic retrograde cholangiopancreatography with MR cholangiopancreatography in patients with pancreatitis. Radiology 1999; 210: 605-610
• 4 Hintze RE, Adler A, Veltzke W et al. Clinical significance of magnetic resonance cholangiopancreatography (MRCP) compared to endoscopic retrograde cholangiopancreatography (ERCP). Endoscopy 1997; 29: 182-187
• 5 Schlaudraff E, Wagner H-J, Klose KJ et al. Prospective evaluation of the diagnostic accuracy of secretin-enhanced magnetic resonance cholangiopancreaticography in suspected chronic pancreatitis. Magn Reson Imaging 2008; 26: 1367-1373
• 6 Morgan DE, Baron TH, Smith JK et al. Pancreatic fluid collections prior to intervention: evaluation with MR imaging compared with CT and US. Radiology 1997; 203: 773-778
• 7 Hart AR, Kennedy H, Harvey I. Pancreatic cancer: a review of the evidence on causation. Clin Gastroenterol Hepatol 2008; 6: 275-282
• 8 Varadarajulu S, Tamhane A, Eloubeidi MA. Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis. Gastrointest Endosc 2005; 62: 728-736 ; quiz 751, 753
• 9 Arvanitakis M, Van Laethem J-L, Parma J et al. Predictive factors for pancreatic cancer in patients with chronic pancreatitis in association with K-ras gene mutation. Endoscopy 2004; 36: 535-542
• 10 Bipat S, Phoa SSKS, van Delden OM et al. Ultrasonography, computed tomography and magnetic resonance imaging for diagnosis and determining resectability of pancreatic adenocarcinoma: a meta-analysis. J Comput Assist Tomogr 2005; 29: 438-445
• 11 Balthazar EJ. Pancreatitis associated with pancreatic carcinoma. Preoperative diagnosis: role of CT imaging in detection and evaluation. Pancreatology 2005; 5: 330-344
• 12 Yamada Y, Mori H, Matsumoto S et al. Pancreatic adenocarcinoma versus chronic pancreatitis: differentiation with triple-phase helical CT. Abdom Imaging 2010; 35: 163-171
• 13 Gerstenmaier JF, Malone DE. Mass lesions in chronic pancreatitis: benign or malignant? An “evidence-based practice” approach. . Abdom Imaging 2011; 36: 569-577
• 14 Ardengh JC, Lopes CV, Campos AD et al. Endoscopic ultrasound and fine needle aspiration in chronic pancreatitis: differential diagnosis between pseudotumoral masses and pancreatic cancer. JOP 2007; 8: 413-421
• 15 Kaufman AR, Sivak MV. Endoscopic ultrasonography in the differential diagnosis of pancreatic disease. Gastrointest Endosc 1989; 35: 214-219
• 16 Fritscher-Ravens A, Brand L, Knöfel WT et al. Comparison of endoscopic ultrasound-guided fine needle aspiration for focal pancreatic lesions in patients with normal parenchyma and chronic pancreatitis. Am J Gastroenterol 2002; 97: 2768-2775
• 17 Krishna NB, Mehra M, Reddy AV et al. EUS/EUS-FNA for suspected pancreatic cancer: influence of chronic pancreatitis and clinical presentation with or without obstructive jaundice on performance characteristics. Gastrointest Endosc 2009; 70: 70-79
• 18 Dumonceau J-M, Polkowski M, Larghi A et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2011; 43: 897-912
• 19 Dumonceau JM, Tringali A, Blero D et al. Biliary stenting: indications, choice of stents and results. ESGE Clinical Guideline. Endoscopy 2012; 44: 277-298
• 20 Dumonceau J-M, Macias GomezC, Casco C et al. Grasp or brush for biliary sampling at endoscopic retrograde cholangiography? A blinded randomized controlled trial. Am J Gastroenterol 2008; 103: 333-340
• 21 Shimosegawa T, Chari ST, Frulloni L et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas 2011; 40: 352-358
• 22 Tanaka M, Chari S, Adsay V et al. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. Pancreatology 2006; 6: 17-32
• 23 Talamini G, Zamboni G, Salvia R et al. Intraductal papillary mucinous neoplasms and chronic pancreatitis. Pancreatology 2006; 6: 626-634
• 24 Díte P, Ruzicka M, Zboril V et al. A prospective, randomized trial comparing endoscopic and surgical therapy for chronic pancreatitis. Endoscopy 2003; 35: 553-558
• 25 Cahen DL, Gouma DJ, Nio Y et al. Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med 2007; 356: 676-684
• 26 Cahen DL, Gouma DJ, Laramée P et al. Long-term outcomes of endoscopic vs surgical drainage of the pancreatic duct in patients with chronic pancreatitis. Gastroenterology 2011; 141: 1690-1695
• 27 Diener MK, Rahbari NN, Fischer L et al. Duodenum-preserving pancreatic head resection versus pancreatoduodenectomy for surgical treatment of chronic pancreatitis: a systematic review and meta-analysis. Ann Surg 2008; 247: 950-961
• 28 Isaji S. Has the Partington procedure for chronic pancreatitis become a thing of the past? A review of the evidence. J Hepatobiliary Pancreat Sci 2010; 17: 763-769
• 29 Tandan M, Reddy DN, Santosh D et al. Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi – a large single center experience. Indian J Gastroenterol 2010; 29: 143-148
• 30 Hookey LC, RioTinto R, Delhaye M et al. Risk factors for pancreatitis after pancreatic sphincterotomy: a review of 572 cases. Endoscopy 2006; 38: 670-676
• 31 Dumonceau J-M, Andriulli A, Deviere J et al. European Society of Gastrointestinal Endoscopy (ESGE) Guideline: prophylaxis of post-ERCP pancreatitis. Endoscopy 2010; 42: 503-515
• 32 Sarner M, Cotton PB. Classification of pancreatitis. Gut 1984; 25: 756-759
• 33 Okolo PI, Pasricha PJ, Kalloo AN. What are the long-term results of endoscopic pancreatic sphincterotomy?. Gastrointest Endosc 2000; 52: 15-19
• 34 Dumonceau J-M, Costamagna G, Tringali A et al. Treatment for painful calcified chronic pancreatitis: extracorporeal shock wave lithotripsy versus endoscopic treatment: a randomised controlled trial. Gut 2007; 56: 545-552
• 35 Dumonceau JM, Devière J, Le Moine O et al. Endoscopic pancreatic drainage in chronic pancreatitis associated with ductal stones: long-term results. Gastrointest Endosc 1996; 43: 547-555
• 36 Delhaye M, Arvanitakis M, Verset G et al. Long-term clinical outcome after endoscopic pancreatic ductal drainage for patients with painful chronic pancreatitis. Clin Gastroenterol Hepatol 2004; 2: 1096-1106
• 37 Farnbacher MJ, Mühldorfer S, Wehler M et al. Interventional endoscopic therapy in chronic pancreatitis including temporary stenting: a definitive treatment?. Scand J Gastroenterol 2006; 41: 111-117
• 38 Tadenuma H, Ishihara T, Yamaguchi T et al. Long-term results of extracorporeal shockwave lithotripsy and endoscopic therapy for pancreatic stones. Clin Gastroenterol Hepatol 2005; 3: 1128-1135
• 39 Mariani A, Bernard JP, Provansal-Cheylan M et al. Differences of pancreatic stone morphology and content in patients with pancreatic lithiasis. Dig Dis Sci 1991; 36: 1509-1516
• 40 Brand B, Kahl M, Sidhu S et al. Prospective evaluation of morphology, function, and quality of life after extracorporeal shockwave lithotripsy and endoscopic treatment of chronic calcific pancreatitis. Am J Gastroenterol 2000; 95: 3428-3438
• 41 Delhaye M, Vandermeeren A, Baize M et al. Extracorporeal shock-wave lithotripsy of pancreatic calculi. Gastroenterology 1992; 102: 610-620
• 42 Farnbacher MJ, Schoen C, Rabenstein T et al. Pancreatic duct stones in chronic pancreatitis: criteria for treatment intensity and success. Gastrointest Endosc 2002; 56: 501-506
• 43 Thomas M, Howell DA, Carr-Locke D et al. Mechanical lithotripsy of pancreatic and biliary stones: complications and available treatment options collected from expert centers. Am J Gastroenterol 2007; 102: 1896-1902
• 44 Nguyen-Tang T, Dumonceau J-M. Endoscopic treatment in chronic pancreatitis, timing, duration and type of intervention. Best Pract Res Clin Gastroenterol 2010; 24: 281-298
• 45 Inui K, Tazuma S, Yamaguchi T et al. Treatment of pancreatic stones with extracorporeal shock wave lithotripsy: results of a multicenter survey. Pancreas 2005; 30: 26-30
• 46 Guda NM, Partington S, Freeman ML. Extracorporeal shock wave lithotripsy in the management of chronic calcific pancreatitis: a meta-analysis. JOP 2005; 6: 6-12
• 47 Adamek HE, Jakobs R, Buttmann A et al. Long term follow up of patients with chronic pancreatitis and pancreatic stones treated with extracorporeal shock wave lithotripsy. Gut 1999; 45: 402-405
• 48 Kozarek RA, Brandabur JJ, Ball TJ et al. Clinical outcomes in patients who undergo extracorporeal shock wave lithotripsy for chronic calcific pancreatitis. Gastrointestinal Endoscopy 2002; 56: 496-500
• 49 Ohara H, Hoshino M, Hayakawa T et al. Single application extracorporeal shock wave lithotripsy is the first choice for patients with pancreatic duct stones. Am J Gastroenterol 1996; 91: 1388-1394
• 50 Delhaye M. Extracorporeal shock wave lithotripsy for pancreatic stones. UpToDate 2011; 1-9 Available at: http://wwwuptodatecom/contents/extracorporeal-shock-wave-lithotripsy-for-pancreatic-stones?source=search_result&selectedTitle=1%7E150 Accessed: Apr 30 2011
• 51 Platonov MA, Gillis AM, Kavanagh KM. Pacemakers, implantable cardioverter/defibrillators, and extracorporeal shockwave lithotripsy: evidence-based guidelines for the modern era. J Endourol 2008; 22: 243-247
• 52 Hirai T, Goto H, Hirooka Y et al. Pilot study of pancreatoscopic lithotripsy using a 5-fr instrument: selected patients may benefit. Endoscopy 2004; 36: 212-216
• 53 Howell DA, Dy RM, Hanson BL et al. Endoscopic treatment of pancreatic duct stones using a 10F pancreatoscope and electrohydraulic lithotripsy. Gastrointest Endosc 1999; 50: 829-833
• 54 Noda A, Shibata T, Hamano H et al. Trimethadione (troxidone) dissolves pancreatic stones. Lancet 1984; 2: 351-353
• 55 Sarles H, Verine H, Lohse J et al. [Dissolution of pancreatic calculi during prolonged oral administration of citrate]. Nouv Presse Med 1979; 8: 1767-1768
• 56 Delhaye M, Matos C, Devière J. Endoscopic management of chronic pancreatitis. Gastrointest Endosc Clin N Am 2003; 13: 717-742
• 57 Dumonceau JM, Heresbach D, Deviere J et al. Biliary stents: models and methods for endoscopic stenting European Society of Gastrointestinal Endoscopy (ESGE) Technology Review. Endoscopy 2011; 43: 617-626
• 58 Cremer M, Devière J, Delhaye M et al. Stenting in severe chronic pancreatitis: results of medium-term follow-up in seventy-six patients. Endoscopy 1991; 23: 171-176
• 59 Ponchon T, Bory RM, Hedelius F et al. Endoscopic stenting for pain relief in chronic pancreatitis: results of a standardized protocol. Gastrointest Endosc 1995; 42: 452-456
• 60 Smits ME, Badiga SM, Rauws EA et al. Long-term results of pancreatic stents in chronic pancreatitis. Gastrointest Endosc 1995; 42: 461-467
• 61 Vitale GC, Cothron K, Vitale EA et al. Role of pancreatic duct stenting in the treatment of chronic pancreatitis. Surg Endosc 2004; 18: 1431-1434
• 62 Eleftherladis N, Dinu F, Delhaye M et al. Long-term outcome after pancreatic stenting in severe chronic pancreatitis. Endoscopy 2005; 37: 223-230
• 63 Ishihara T, Yamaguchi T, Seza K et al. Efficacy of s-type stents for the treatment of the main pancreatic duct stricture in patients with chronic pancreatitis. Scand J Gastroenterol 2006; 41: 744-750
• 64 Weber A, Schneider J, Neu B et al. Endoscopic stent therapy for patients with chronic pancreatitis: results from a prospective follow-up study. Pancreas 2007; 34: 287-294
• 65 Boursier J, Quentin V, Le Tallec V et al. Endoscopic treatment of painful chronic pancreatitis: Evaluation of a new flexible multiperforated plastic stent. Gastroenterol Clin Biol 2008; 32: 801-805
• 66 Kim MH, Myung SJ, Kim YS et al. Routine biliary sphincterotomy may not be indispensable for endoscopic pancreatic sphincterotomy. Endoscopy 1998; 30: 697-701
• 67 Ziebert JJ, DiSario JA. Dilation of refractory pancreatic duct strictures: the turn of the screw. Gastrointest Endosc 1999; 49: 632-635
• 68 Binmoeller KF, Jue P, Seifert H et al. Endoscopic pancreatic stent drainage in chronic pancreatitis and a dominant stricture: long-term results. Endoscopy 1995; 27: 638-644
• 69 Morgan DE, Smith JK, Hawkins K et al. Endoscopic stent therapy in advanced chronic pancreatitis: relationships between ductal changes, clinical response, and stent patency. Am J Gastroenterol 2003; 98: 821-826
• 70 Sauer BG, Gurka MJ, Ellen K et al. Effect of pancreatic duct stent diameter on hospitalization in chronic pancreatitis: does size matter?. Pancreas 2009; 38: 728-731
• 71 Costamagna G, Bulajic M, Tringali A et al. Multiple stenting of refractory pancreatic duct strictures in severe chronic pancreatitis: long-term results. Endoscopy 2006; 38: 254-259
• 72 Eisendrath P, Devière J. Expandable metal stents for benign pancreatic duct obstruction. Gastrointest Endosc Clin N Am 1999; 9: 547-554
• 73 Park DH, Kim M-H, Moon S-H et al. Feasibility and safety of placement of a newly designed, fully covered self-expandable metal stent for refractory benign pancreatic ductal strictures: a pilot study (with video). Gastrointest Endosc 2008; 68: 1182-1189
• 74 Sauer B, Talreja J, Ellen K et al. Temporary placement of a fully covered self-expandable metal stent in the pancreatic duct for management of symptomatic refractory chronic pancreatitis: preliminary data (with videos). Gastrointest Endosc 2008; 68: 1173-1178
• 75 Moon S-H, Kim M-H, Park DH et al. Modified fully covered self-expandable metal stents with antimigration features for benign pancreatic-duct strictures in advanced chronic pancreatitis, with a focus on the safety profile and reducing migration. Gastrointest Endosc 2010; 72: 86-91
• 76 François E, Kahaleh M, Giovannini M et al. EUS-guided pancreaticogastrostomy. Gastrointest Endosc 2002; 56: 128-133
• 77 Mallery S, Matlock J, Freeman ML. EUS-guided rendezvous drainage of obstructed biliary and pancreatic ducts: Report of 6 cases. Gastrointest Endosc 2004; 59: 100-107
• 78 Will U, Fueldner F, Thieme A-K et al. Transgastric pancreatography and EUS-guided drainage of the pancreatic duct. J Hepatobiliary Pancreat Surg 2007; 14: 377-382
• 79 Tessier G, Bories E, Arvanitakis M et al. EUS-guided pancreatogastrostomy and pancreatobulbostomy for the treatment of pain in patients with pancreatic ductal dilatation inaccessible for transpapillary endoscopic therapy. Gastrointest Endosc 2007; 65: 233-241
• 80 Kahaleh M, Hernandez AJ, Tokar J et al. EUS-guided pancreaticogastrostomy: analysis of its efficacy to drain inaccessible pancreatic ducts. Gastrointest Endosc 2007; 65: 224-230
• 81 Brauer BC, Chen YK, Fukami N et al. Single-operator EUS-guided cholangiopancreatography for difficult pancreaticobiliary access (with video). Gastrointest Endosc 2009; 70: 471-479
• 82 Pateman J, Williams MP, Filshie J. Retroperitoneal fibrosis after multiple coeliac plexus blocks. Anaesthesia 1990; 45: 309-310
• 83 Puli SR, Reddy JBK, Bechtold ML et al. EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain: a meta-analysis and systematic review. Dig Dis Sci 2009; 54: 2330-2337
• 84 Kaufman M, Singh G, Das S et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol 2010; 44: 127-134
• 85 Gress F, Schmitt C, Sherman S et al. Endoscopic ultrasound-guided celiac plexus block for managing abdominal pain associated with chronic pancreatitis: a prospective single center experience. Am J Gastroenterol 2001; 96: 409-416
• 86 Stevens T, Costanzo A, Lopez R et al. Adding triamcinolone to endoscopic ultrasound-guided celiac plexus blockade does not reduce pain in patients with chronic pancreatitis. Clin Gastroenterol Hepatol 2012; 10: 186-191 e181
• 87 Gress F, Schmitt C, Sherman S et al. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol 1999; 94: 900-905
• 88 Santosh D, Lakhtakia S, Gupta R et al. Clinical trial: a randomized trial comparing fluoroscopy guided percutaneous technique vs. endoscopic ultrasound guided technique of coeliac plexus block for treatment of pain in chronic pancreatitis. Aliment Pharmacol Ther 2009; 29: 979-984
• 89 Sett SS, Taylor DC. Aortic pseudoaneurysm secondary to celiac plexus block. Ann Vasc Surg 1991; 5: 88-91
• 90 Davies DD. Incidence of major complications of neurolytic coeliac plexus block. J R Soc Med 1993; 86: 264-266
• 91 Andrén-Sandberg A, Dervenis C. Pancreatic pseudocysts in the 21st century. Part I: classification, pathophysiology, anatomic considerations and treatment. JOP 2004; 5: 8-24
• 92 Bradley EL. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993; 128: 586-590
• 93 Barkin JS, Hyder SA. Changing concepts in the management of pancreatic pseudocysts. Gastrointest Endosc 1989; 35: 62-64
• 94 Baron TH, Harewood GC, Morgan DE et al. Outcome differences after endoscopic drainage of pancreatic necrosis, acute pancreatic pseudocysts, and chronic pancreatic pseudocysts. Gastrointest Endosc 2002; 56: 7-17
• 95 Barthet M, Lamblin G, Gasmi M et al. Clinical usefulness of a treatment algorithm for pancreatic pseudocysts. Gastrointest Endosc 2008; 67: 245-252
• 96 Cahen D, Rauws E, Fockens P et al. Endoscopic drainage of pancreatic pseudocysts: long-term outcome and procedural factors associated with safe and successful treatment. Endoscopy 2005; 37: 977-983
• 97 Park DH, Lee SS, Moon S-H et al. Endoscopic ultrasound-guided versus conventional transmural drainage for pancreatic pseudocysts: a prospective randomized trial. Endoscopy 2009; 41: 842-848
• 98 Hookey LC, Debroux S, Delhaye M et al. Endoscopic drainage of pancreatic-fluid collections in 116 patients: a comparison of etiologies, drainage techniques, and outcomes. Gastrointest Endosc 2006; 63: 635-643
• 99 Kahaleh M, Shami VM, Conaway MR et al. Endoscopic ultrasound drainage of pancreatic pseudocyst: a prospective comparison with conventional endoscopic drainage. Endoscopy 2006; 38: 355-359
• 100 Jacobson BC, Baron TH, Adler DG et al. ASGE guideline: The role of endoscopy in the diagnosis and the management of cystic lesions and inflammatory fluid collections of the pancreas. Gastrointest Endosc 2005; 61: 363-370
• 101 Vitas GJ, Sarr MG. Selected management of pancreatic pseudocysts: operative versus expectant management. Surgery 1992; 111: 123-130
• 102 Yeo CJ, Bastidas JA, Lynch-Nyhan A et al. The natural history of pancreatic pseudocysts documented by computed tomography. Surg Gynecol Obstet 1990; 170: 411-417
• 103 Lerch MM, Stier A, Wahnschaffe U et al. Pancreatic pseudocysts: observation, endoscopic drainage, or resection?. Dtsch Arztebl Int 2009; 106: 614-621
• 104 Andrén-Sandberg A, Dervenis C. Pancreatic pseudocysts in the 21st century. Part II: natural history. JOP 2004; 5: 64-70
• 105 Gouyon B, Lévy P, Ruszniewski P et al. Predictive factors in the outcome of pseudocysts complicating alcoholic chronic pancreatitis. Gut 1997; 41: 821-825
• 106 Varadarajulu S, Trevino J, Wilcox CM et al. Randomized trial comparing EUS and surgery for pancreatic pseudocyst drainage. Gastrointest Endosc 2010; 71: AB116-AB116
• 107 Rosso E, Alexakis N, Ghaneh P et al. Pancreatic pseudocyst in chronic pancreatitis: endoscopic and surgical treatment. Dig Surg 2003; 20: 397-406
• 108 Binmoeller KF, Seifert H, Walter A et al. Transpapillary and transmural drainage of pancreatic pseudocysts. Gastrointest Endosc 1995; 42: 219-224
• 109 Varadarajulu S, Christein JD, Tamhane A et al. Prospective randomized trial comparing EUS and EGD for transmural drainage of pancreatic pseudocysts (with videos). Gastrointest Endosc 2008; 68: 1102-1111
• 110 Beckingham IJ, Krige JE, Bornman PC et al. Endoscopic management of pancreatic pseudocysts. Br J Surg 1997; 84: 1638-1645
• 111 Funnell IC, Bornman PC, Krige JE et al. Endoscopic drainage of traumatic pancreatic pseudocyst. Br J Surg 1994; 81: 879-881
• 112 Cremer M, Deviere J, Engelholm L. Endoscopic management of cysts and pseudocysts in chronic pancreatitis: long-term follow-up after 7 years of experience. Gastrointest Endosc 1989; 35: 1-9
• 113 Arvanitakis M, Delhaye M, Bali MA et al. Pancreatic-fluid collections: a randomized controlled trial regarding stent removal after endoscopic transmural drainage. Gastrointest Endosc 2007; 65: 609-619
• 114 Balachandra S, Siriwardena AK. Systematic appraisal of the management of the major vascular complications of pancreatitis. Am J Surg 2005; 190: 489-495
• 115 Delhaye M, Matos C, Devière J. Endoscopic technique for the management of pancreatitis and its complications. Best Pract Res Clin Gastroenterol 2004; 18: 155-181
• 116 Bernades P, Baetz A, Lévy P et al. Splenic and portal venous obstruction in chronic pancreatitis. A prospective longitudinal study of a medical-surgical series of 266 patients. Dig Dis Sci 1992; 37: 340-346
• 117 Breslin N, Wallace MB. Diagnosis and fine needle aspiration of pancreatic pseudocysts: the role of endoscopic ultrasound. Gastrointest Endosc Clin N Am 2002; 12: 781-790 , viii
• 118 Sriram PV, Kaffes AJ, Rao GV et al. Endoscopic ultrasound-guided drainage of pancreatic pseudocysts complicated by portal hypertension or by intervening vessels. Endoscopy 2005; 37: 231-235
• 119 Lawrence C, Howell DA, Stefan AM et al. Disconnected pancreatic tail syndrome: potential for endoscopic therapy and results of long-term follow-up. Gastrointest Endosc 2008; 67: 673-679
• 120 Varadarajulu S, Noone TC, Tutuian R et al. Predictors of outcome in pancreatic duct disruption managed by endoscopic transpapillary stent placement. Gastrointest Endosc 2005; 61: 568-575
• 121 Devière J, Bueso H, Baize M et al. Complete disruption of the main pancreatic duct: endoscopic management. Gastrointest Endosc 1995; 42: 445-451
• 122 Pelaez-Luna M, Vege SS, Petersen BT et al. Disconnected pancreatic duct syndrome in severe acute pancreatitis: clinical and imaging characteristics and outcomes in a cohort of 31 cases. Gastrointest Endosc 2008; 68: 91-97
• 123 Trevino JM, Tevino JM, Tamhane A et al. Successful stenting in ductal disruption favorably impacts treatment outcomes in patients undergoing transmural drainage of peripancreatic fluid collections. J Gastroenterol Hepatol 2010; 25: 526-531
• 124 Golzarian J, Nicaise N, Devière J et al. Transcatheter embolization of pseudoaneurysms complicating pancreatitis. Cardiovasc Intervent Radiol 1997; 20: 435-440
• 125 Smits ME, Rauws EA, Tytgat GN et al. The efficacy of endoscopic treatment of pancreatic pseudocysts. Gastrointest Endosc 1995; 42: 202-207
• 126 Banerjee S, Shen B, Baron TH et al. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2008; 67: 791-798
• 127 Abdallah AA, Krige JEJ, Bornman PC. Biliary tract obstruction in chronic pancreatitis. HPB (Oxford) 2007; 9: 421-428
• 128 Sarles H, Sahel J. Cholestasis and lesions of the biliary tract in chronic pancreatitis. Gut 1978; 19: 851-857
• 129 Frey CF, Suzuki M, Isaji S. Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. World J Surg 1990; 14: 59-69
• 130 Kahaleh M, Behm B, Clarke BW et al. Temporary placement of covered self-expandable metal stents in benign biliary strictures: a new paradigm? (with video). Gastrointest Endosc 2008; 67: 446-454
• 131 Tabibian J, Asham E, Goldstein L et al. Endoscopic treatment with multiple stents for post-liver-transplantation nonanastomotic biliary strictures. Gastrointest Endosc 2009; 69: 1236-1243
• 132 Mahajan A, Ho H, Sauer B et al. Temporary placement of fully covered self-expandable metal stents in benign biliary strictures: midterm evaluation (with video). Gastrointest Endosc 2009; 70: 303-309
• 133 Kahl S, Zimmermann S, Genz I et al. Risk factors for failure of endoscopic stenting of biliary strictures in chronic pancreatitis: a prospective follow-up study. Am J Gastroenterol 2003; 98: 2448-2453
• 134 Catalano MF, Linder JD, George S et al. Treatment of symptomatic distal common bile duct stenosis secondary to chronic pancreatitis: comparison of single vs. multiple simultaneous stents. Gastrointest Endosc 2004; 60: 945-952
• 135 Pozsár J, Sahin P, László F et al. Medium-term results of endoscopic treatment of common bile duct strictures in chronic calcifying pancreatitis with increasing numbers of stents. J Clin Gastroenterol 2004; 38: 118-123
• 136 Draganov P, Hoffman B, Marsh W et al. Long-term outcome in patients with benign biliary strictures treated endoscopically with multiple stents. Gastrointest Endosc 2002; 55: 680-686
• 137 Lawrence C, Romagnuolo J, Payne KM et al. Low symptomatic premature stent occlusion of multiple plastic stents for benign biliary strictures: comparing standard and prolonged stent change intervals. Gastrointest Endosc 2010; 72: 558-563
• 138 Kiehne K, Fölsch UR, Nitsche R. High complication rate of bile duct stents in patients with chronic alcoholic pancreatitis due to noncompliance. Endoscopy 2000; 32: 377-380
• 139 Morelli G, Fazel A, Judah J et al. Rapid-sequence endoscopic management of posttransplant anastomotic biliary strictures. Gastrointest Endosc 2008; 67: 879-885
• 140 Cahen DL, Rauws EA, Gouma DJ et al. Removable fully covered self-expandable metal stents in the treatment of common bile duct strictures due to chronic pancreatitis: a case series. Endoscopy 2008; 40: 697-700
• 141 Siriwardana HPP, Siriwardena AK. Systematic appraisal of the role of metallic endobiliary stents in the treatment of benign bile duct stricture. Ann Surg 2005; 242: 10-19
• 142 van Boeckel PGA, Vleggaar FP, Siersema PD. Plastic or metal stents for benign extrahepatic biliary strictures: a systematic review. BMC Gastroenterology 2009; 9: 96
• 143 Cantù P, Hookey LC, Morales A et al. The treatment of patients with symptomatic common bile duct stenosis secondary to chronic pancreatitis using partially covered metal stents: a pilot study. Endoscopy 2005; 37: 735-739
• 144 Behm B, Brock A, Clarke BW et al. Partially covered self-expandable metallic stents for benign biliary strictures due to chronic pancreatitis. Endoscopy 2009; 41: 547-551
• 145 Davids PH, Tanka AK, Rauws EA et al. Benign biliary strictures. Surgery or endoscopy?. Ann Surg 1993; 217: 237-243
• 146 Tocchi A, Mazzoni G, Liotta G et al. Management of benign biliary strictures: biliary enteric anastomosis vs endoscopic stenting. Arch Surg 2000; 135: 153-157
• 147 Joergensen M, Brusgaard K, Crüger DG et al. Incidence, prevalence, etiology, and prognosis of first-time chronic pancreatitis in young patients: a nationwide cohort study. Dig Dis Sci 2010; 55: 2988-2998
• 148 Witt H. Gene mutations in children with chronic pancreatitis. Pancreatology 2001; 1: 432-438
• 149 Wang W, Liao Z, Li Z-S et al. Chronic pancreatitis in Chinese children: etiology, clinical presentation and imaging diagnosis. J Gastroenterol Hepatol 2009; 24: 1862-1868
• 150 Iacopini F, Mutignani M, Perri V et al. Chronic pancreatitis: morphologic differences at disease onset between pediatric and adult patients. Gastroenterology 2010; 138: S-395
• 151 Hsu RK, Draganov P, Leung JW et al. Therapeutic ERCP in the management of pancreatitis in children. Gastrointest Endosc 2000; 51: 396-400
• 152 Iqbal CW, Moir CR, Ishitani MB. Management of chronic pancreatitis in the pediatric patient: endoscopic retrograde cholangiopancreatography vs operative therapy. J Pediatr Surg 2009; 44: 139-143 ; discussion 143
• 153 Li Z-S, Wang W, Liao Z et al. A long-term follow-up study on endoscopic management of children and adolescents with chronic pancreatitis. Am J Gastroenterol 2010; 105: 1884-1892
• 154 Dumonceau J-M, Hassan C, Riphaus A et al. European Society of Gastrointestinal Endoscopy (ESGE) Guideline Development Policy. Endoscopy 2012; 44: 626-629
• 155 Deviere J, Devaere S, Baize M et al. Endoscopic biliary drainage in chronic pancreatitis. Gastrointest Endosc 1990; 36: 96-100
• 156 Barthet M, Bernard JP, Duval JL et al. Biliary stenting in benign biliary stenosis complicating chronic calcifying pancreatitis. Endoscopy 1994; 26: 569-572
• 157 Smits ME, Rauws EA, van Gulik TM et al. Long-term results of endoscopic stenting and surgical drainage for biliary stricture due to chronic pancreatitis. Br J Surg 1996; 83: 764-768
• 158 Vitale GC, Reed DN, Nguyen CT et al. Endoscopic treatment of distal bile duct stricture from chronic pancreatitis. Surg Endosc 2000; 14: 227-231
• 159 Farnbacher MJ, Rabenstein T, Ell C et al. Is endoscopic drainage of common bile duct stenoses in chronic pancreatitis up-to-date?. Am J Gastroenterol 2000; 95: 1466-1471
• 160 Eickhoff A, Jakobs R, Leonhardt A et al. Endoscopic stenting for common bile duct stenoses in chronic pancreatitis: results and impact on long-term outcome. Eur J Gastroenterol Hepatol 2001; 13: 1161-1167
• 161 Cahen DL, van Berkel A-MM, Oskam D et al. Long-term results of endoscopic drainage of common bile duct strictures in chronic pancreatitis. Eur J Gastroenterol Hepatol 2005; 17: 103-108