A team from Milwaukee, Wisconsin, USA, evaluated the effectiveness of pancreatic duct stents in preventing attacks of pancreatitis in idiopathic recurrent pancreatitis (IRP).
34 IRP patients were enrolled in the non-blinded prospective controlled trial, over a 5-year period.
Patients were randomly assigned to one of two groups. 19 patients (14 women, mean age 44) were assigned to the pancreatic stent group, and 15 patients (10 women, mean age 47) to the control group.
The stent group received 3 stents over a period of 1 year, and the control group had selective pancreatograms but no stent.
Mean follow-up was 33 and 35 months, in the stent and control groups respectively.
|Recurrence of pancreatitis:|
Stent group: 11%
Episodes of pancreatitis, frequency and intensity of pain requiring emergency room visits, and hospitalizations were recorded.
The researchers found that recurrence of pancreatitis occurred in 8 out of 15 patients (53%) in the control group, but in only 2 out of 19 patients (11%) in the stent group.
2 patients in the control group, who had recurrences of pancreatitis, crossed over to stent therapy and had no further pancreatitis thereafter.
6 patients in both the stent (32%) and control (40%) groups, continued to have pancreatic type pain.
During the study period, 17 stents were occluded and 14 migrated out.
Author L. Jacob, of the Pancreatic Biliary Center, St Luke's Medical Center, Milwaukee, concluded on behalf of the group, "The results of this study suggest that pancreatic duct stenting may prevent recurrent attacks of pancreatitis in IRP patients.
"Intermittent pancreatic duct sphincter dysfunction or relative outlet obstruction may be the underlying cause for the recurrent attacks of pancreatitis."