Researchers from Massachusetts and California, USA, identified predictors of outcome after pancreatic duct stent placement for duct disruption.
A total of 43 patients (23 women, mean age 57 years) were identified from endoscopy databases.
Disruption was defined by extravasation of contrast from the pancreatic duct during endoscopic retrograde pancreatography (ERCP).
Data collected included demographic information, imaging studies, management before, and outcome after stent placement.
The authors defined success as resolution of the disruption clinically, on radiologic imaging, and/or at ERCP.
The etiology of pancreatic duct disruption was acute pancreatitis in 24, chronic pancreatitis in 9, operative injury in 7, and trauma in 3 patients.
| Only the bridging stent position correlated with successful outcome.
| Gastrointestinal Endoscopy |
In 25 patients there was resolution of the disruption, whereas stent therapy was unsuccessful in 16 and the outcome was indeterminate in 2 patients.
On univariate analysis, stent positioned to bridge the disruption and longer duration of stent therapy were associated with a successful outcome.
However, female gender and acute pancreatitis were associated with a lack of success.
On multivariate analysis, only the bridging stent position remained correlated to outcome.
Complications occurred in 4 patients.
Dr Jennifer J. Telford, of the Brigham and Women's Hospital and Massachusetts General Hospital, Boston, Massachusetts, concluded on behalf of her group, "A bridging stent is associated with a successful outcome after pancreatic duct stent placement for duct disruption."