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Endoscopic Treatment of Chronic Pancreatitis: A Multicenter Study of 1000 Patients with Long-Term Follow-Up
Submitted: 15 January 2002
Accepted after Revision: 15 April 2002
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 ·
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