Pancreatic stents can induce ductal changes consistent with chronic pancreatitis

Pancreatic duct stents have recently been placed for a variety of acute and chronic pancreatic lesions. Although complications have occurred, there are no data to suggest that the stents themselves induce ductal changes. In a retrospective review of 34 patients having 38 pancreatic duct stents placed for disrupted ducts, isolated strictures, pancrease divisum, and hypertensive pancreatic sphincters, 36% of all patients (72% of patients who had normal initial pancreatograms) were found to have subsequent ductal changes. Such changes were related either to stent occlusion (pseudocyst, diffuse duct enlargement) and direct stent trauma or side branch occlusion (irregular stenoses, side branch ectasia). Whereas the former resolved with stent retrieval or exchange, it remains uncertain what the long-term consequences of the latter changes will be, despite a tendency for the abnormal pancreatograms to improve with time. Further experience is needed with pancreatic stenting before widespread application of this technique.