Clin Endosc > Epub ahead of print
A Prospective Study of Fully Covered Self-Expandable Metal Stents for Refractory Benign Pancreatic Duct Strictures
Bhavik Bharat Shah1 , Gajanan Ashokrao Rodge1 , Usha Goenka2 , Shivaraj Afzalpurkar1 , Mahesh Kumar Goenka1
1Institute of Gastrosciences & Liver, Apollo Multispeciality Hospital, Kolkata, India
2Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospital, Kolkata, India
Correspondence :  Mahesh Kumar Goenka ,Tel: +91-983-004-0599, Fax: +91-033-232-05218, Email: mkgkolkata@gmail.com
Received: July 30, 2021  Revised: October 19, 2021   Accepted: November 8, 2021
Abstract

Background/Aims:
Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pancreatic duct (MPD) 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 (ERP) with FCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale (VAS) 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 ERP 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 VAS 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 MPD strictures.
Key Words: Efficacy; Feasibility; Fully covered self-expanding metal stents; Refractory pancreatic duct strictures; Safety
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