Endoscopic Treatment of Chronic Pancreatitis: A Multicenter Study of 1000 Patients with Long-Term Follow-Up

T. Rösch; S. Daniel; M. Scholz; K. Huibregtse; M. Smits; T. Schneider; C. Ell; G. Haber; J.-F. Riemann; R. Jakobs; R. Hintze; A. Adler; H. Neuhaus; M. Zavoral; F. Zavada; V. Schusdziarra; N. Soehendra; null for the European Society of Gastrointestinal Endoscopy Research

doi:10.1055/s-2002-34256

Endoscopy 2002; 34(10): 765-771
DOI: 10.1055/s-2002-34256

Original Article

Endoscopic Treatment of Chronic Pancreatitis: A Multicenter Study of 1000 Patients with Long-Term Follow-Up

T. Rösch ¹ , S. Daniel ¹ , M. Scholz ¹ , K. Huibregtse² , M. Smits ² , T. Schneider ³ , C. Ell ³ , G. Haber ⁴ , J.-F. Riemann ⁵ , R. Jakobs ⁵ , R. Hintze ⁶ , A. Adler ⁶ , H. Neuhaus ¹ , M. Zavoral ⁷ , F. Zavada ⁷ , V. Schusdziarra ¹ , N. Soehendra ⁸ , for the European Society of Gastrointestinal Endoscopy Research Group

¹Dept. of Internal Medicine II and Dept. of Medical Statistics and Epidemiology, Technical University of Munich, Germany
²Dept. of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands
³Dept. of Internal Medicine I, Friedrich-Alexander University, Erlangen, Germany
⁴Dept. of Gastroenterology, Wellesley Hospital, Toronto, Canada
⁵Dept. of Medicine C, Ludwigshafen Hospital, Germany
⁶Interdisciplinary Endoscopy Dept., Virchow University Hospital, Berlin, Germany
⁷Dept. of Internal Medicine II, Central Military Hospital, Prague, Czech Republic
⁸Dept. of Endoscopic Surgery, Eppendorf University Hospital, Hamburg, Germany

Abstract

Background and Study Aims: Endoscopic ductal decompression therapy has become an established method of treating patients with painful obstructive chronic pancreatitis. Smaller series, mostly with a medium-term follow-up period, have reported encouraging results. The present analysis presents long-term follow-up data from a large multicenter patient cohort.
Patients and Methods: Patients with painful chronic pancreatitis and with ductal obstruction due to either strictures and/or stones treated endoscopically at eight different centers underwent follow-up after 2 - 12 years (mean 4.9 years). The patients’ clinical data, the rate of technical success, and complications were recorded from the charts. Follow-up data were prospectively obtained using structured questionnaires; the main parameter for evaluating treatment success was a significant reduction in pain (no pain or only weak pain).
Results: Follow-up data were obtained from 1018 of 1211 patients treated (84 %) with mainly strictures (47 %), stones (18 %), or strictures plus stones (32 %). At the long-term follow-up, 60 % of the patients had their endotherapy completed, 16 % were still receiving some form of endoscopic treatment, and 24 % had undergone surgery. The long-term success of endotherapy was 86 % in the entire group, but only 65 % in an intention-to-treat analysis. There were no significant differences between the patient groups with regard to either strictures, stones, or both. Pancreatic function was not positively affected by endoscopic therapy.
Conclusions: Endoscopic ductal decompression therapy offers relief of pain in two-thirds of the patients when it is used as the only form of treatment. One-quarter of the patients have to undergo surgery.

Full Text

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T. Rösch, M.D.

Dept. of Internal Medicine II · Technical University of Munich · Klinikum rechts der Isar

Ismaningerstrasse 22 · 81675 München · Germany ·

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Email: Thomas.Roesch@lrz.tu-muenchen.de