Long-term outcome of endoscopic stent placement for chronic pancreatitis associated with pancreas divisum

In pancreas divisum (PD), endoscopic drainage of the minor papilla is beneficial for patients presenting with acute recurrent pancreatitis, but in cases of chronic pancreatitis, surgery is claimed to be indicated. The aim of this study was to evaluate the efficacy of endoscopic stent placement in patients with PD presenting with chronic pancreatitis.

The outcome of endoscopic treatment was evaluated in 16 patients with PD presenting with chronic pancreatitis, who underwent stenting as a first line of treatment. Chart reviews and patient interviews by mail and telephone were conducted. Median follow-up time was 51 months (range 6-120).

After one episode of stenting and subsequent stent extraction, five of 16 patients remained pain-free (i.e., for a median time of 45 months, range 12-64). Six patients had temporary pain relief (14 months), and five patients experienced no effect of stent therapy. A total of five patients underwent surgery after failure of stenting.

Patients with chronic pancreatitis and a PD should undergo trial stenting, since every third patient remains symptom-free after one episode of stenting.