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A prospective study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures
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Bhavik Bharat Shah, Gajanan Ashokrao Rodge, Usha Goenka, Shivaraj Afzalpurkar, Mahesh Kumar Goenka
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Clin Endosc 2022;55(6):793-800. Published online April 4, 2022
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DOI: https://doi.org/10.5946/ce.2021.211
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Abstract
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- Background
/Aims: Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pancreatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety of FCSEMSs in this patient group.
Methods This prospective single-center study included patients who underwent endoscopic retrograde pancreatography with FCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain score of >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreatic strictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events.
Results Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was 86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The mean visual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were asymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancreatitis (2.8%) were the most common adverse events.
Conclusions FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractory main pancreatic duct strictures.
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Citations
Citations to this article as recorded by 
- A review on pancreatic duct stents: materials and emerging trends
Huijuan Fan, Nan Li, Xingguang Zhang, Wei Xu, Wencheng Zhang, Yangjuan Ding, Lingjian Li, Taotao Liu, Shihai Xia Biomedical Materials.2025; 20(3): 032004. CrossRef - Citric Acid Loaded Hydrogel-Coated Stent for Dissolving Pancreatic Duct Calculi
Jing Li, Yanwei Lv, Zheng Chen, Jiulong Zhao, Shige Wang Gels.2024; 10(2): 125. CrossRef - Fully Covered Self-expandable Metallic Stents for Refractory Benign Pancreatic Duct Strictures: A Systematic Review and Meta-analysis
Gajanan Rodge, Suprabhat Giri, Kailash Kolhe, Shivaraj Afzalpurkar, Sidharth Harindranath, Sridhar Sundaram, Aditya Kale Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(5): 529. CrossRef - Self-expanding metallic stent for refractory pancreatic duct stricture in chronic pancreatitis: A prospective follow-up study
Praveer Rai, Pankaj Kumar, Ashok Kumar, Sana Asari, Kartik Agarwal, Mayank, Ravi V. Krishna Kishore, Prabhaker Mishra Indian Journal of Gastroenterology.2023;[Epub] CrossRef - Quality of life after endoscopic procedures for chronic pancreatitis: A multicentre study
Mikael Parhiala, Camilla Nøjgaard, Andreas Bartholdy, Anne Waage, Povilas Ignatavičius, Trond Engjom, Georg Dimcevski, Ingrid Kvåle Nordaas, Evangelos Kalaitzakis, Asbjørn M. Drewes, Amer Hadi, Søren S. Olesen, Jakob L. Poulsen, Johanna Laukkarinen United European Gastroenterology Journal.2023; 11(9): 884. CrossRef - Pancreatic duct stents
Jin Hui Yi, Zhao Shen Li, Liang Hao Hu Journal of Digestive Diseases.2022; 23(12): 675. CrossRef
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Endoscopic Management with a Novel Over-The-Scope Padlock Clip System
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Mahesh Kumar Goenka, Gajanan Ashokrao Rodge, Indrajeet Kumar Tiwary
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Clin Endosc 2019;52(6):574-580. Published online November 26, 2019
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DOI: https://doi.org/10.5946/ce.2019.122
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Abstract
PDF PubReader ePub
- Background
/Aims: The Padlock clip is a recently introduced over-the-scope clip (OTSC) that requires the use of an alternate technique and has a different design from previous OTSCs. However, data regarding its clinical use are limited. The aim of this study is to present our clinical experience using this novel Padlock clip system.
Methods Between September 2018 and June 2019, 7 consecutive patients underwent Padlock clip application at our center by an experienced endoscopist. A Padlock clip was used for achieving hemostasis in 4 patients presenting with gastrointestinal (GI) bleeding, as well as for endoscopic full-thickness resection in the remaining 3 patients.
Results All 7 patients achieved technical as well as clinical success, with absence of complications or rebleeding, during a follow-up of a minimum of 3 weeks. All patients were hospitalized post procedure for a minimum of 48 hours, and an absence of adverse events was noted in our patient population throughout the procedure and post-procedure period. Antiplatelet therapy was reinstated shortly after the application of the Padlock clip, with no GI bleeding observed.
Conclusions The Padlock clip is a novel OTSC, with benefits that include safe, simple, and rapid deployment. Antiplatelet therapy may be reinstated for patients, when necessary, shortly after applying the Padlock clip due to full-thickness closure of the tissue.
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Citations
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Natalie Wilson, Moamen Gabr, Mohammad Bilal Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 385. CrossRef - Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review
Alexandra Menni, George Stavrou, Georgios Tzikos, Anne D. Shrewsbury, Katerina Kotzampassi Gastrointestinal Disorders.2023; 5(3): 383. CrossRef - Boerhaave’s Syndrome: Better Late than Never – Delayed Management Using Endoscopic Over-the-Scope Clip
Arulprakash Sarangapani, Tarun J George, S Malathi Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(4): 167. CrossRef - Tratamiento endoscópico de la perforación mediante Padlock Clip®, a propósito de 2 casos
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Lian Yong Li, Bai Wen Li, Parit Mekaroonkamol, Hui Min Chen, Shan Shan Shen, Hui Luo, Sunil Dacha, Yue Xue, Sarah Cristofaro, Steven Keilin, Field Willingham, Qiang Cai Journal of Digestive Diseases.2020; 21(4): 215. CrossRef - Another Use for Padlock Clip
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Darshan Suthar, Elisabeth H Kramer, Harshit S Khara Cureus.2020;[Epub] CrossRef
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