[Pancreatic intubation by endoscopy in chronic calcifying pancreatitis]

The aim of our study was to assess the efficacy of endoscopic pancreatic stenting on pain and frequency of acute pancreatitis in patients with calcifying chronic pancreatitis.

Between 1987 and 1996, 70 patients underwent endoscopic management for calcifying chronic pancreatitis.

Endoscopic stent placement was successful in 59 patients (85%). 46 patients were followed for a mean duration of 29 +/- 26.4 months after stent removal. The presence of pancreatic pseudocysts in 26 patients appeared to modify pain improvement rate but did not influence the decrease in the frequency of acute pancreatitis. An improvement of pancreatic pain occurred at the end of stenting and after removal of the stent in respectively 44% and 38% of the patients without pseudocysts and in 85% (P < 0.02) and 65% of the patients presenting with pancreatic pseudocysts. Before stenting, 43/70 (61%) patients had at least two episodes of acute pancreatitis. After removal of the stent, only 5/46 (11%) had one episode of acute pancreatitis. Improvement of weight loss and diabetes was observed in respectively 28 cases (52%), 7 cases (39%) at the end of pancreatic stenting and was still persisting in 21 (51%) and 5 cases (26%) after removal of the stent.

After pancreatic stenting, the improvement of pain appears to be moderate in the absence of pancreatic pseudocyst. Nevertheless, the improvement of pain is maintained after stent removal. Moreover, the frequency of acute pancreatitis is significantly decreased after pancreatic stenting.