Endoscopy 2002; 34(10): 765-771
DOI: 10.1055/s-2002-34256
Original Article
© Georg Thieme Verlag Stuttgart · New York

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
Further Information

Publication History

Submitted: 15 January 2002

Accepted after Revision: 15 April 2002

Publication Date:
23 September 2002 (online)

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.

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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 ·

Fax: + 49-89-4140-4872

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