Stent placement in pancreatic disease, when, which and why? - a current perspective

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Surgical Technology

Background:

• Pancreatic stenting is a complex interventional gastroenterology procedure.
• Indications for pancreatic stent placement include prophylactic and therapeutic reasons.
• Effective management requires a deep understanding of available literature and techniques.

Purpose of the Study:

• To provide an overview of current literature and techniques for pancreatic stent placement.
• To discuss prophylactic and therapeutic indications for pancreatic stenting.
• To highlight the role of interventional endoscopy in managing pancreatic duct disorders.

Main Methods:

• A structured literature search was performed on Pubmed.gov.
• Key search terms included: interventional endoscopy, pancreatic stenting, post-ERCP pancreatitis, pancreatic fistulae, and pancreas divisum.
• The review synthesized findings on various stenting techniques and indications.

Main Results:

• Prophylactic stenting uses small, designated stents to prevent post-ERCP pancreatitis (PEP) in high-risk patients.
• Therapeutic stenting restores pancreatic secretion flow in cases of stenosis, leaks, fistulas, or malformations.
• Techniques include plastic stents, self-expanding metal stents (SEMSs), and EUS-guided pancreatic duct access with stenting (including LAMS).

Conclusions:

• Pancreatic stenting is a specialized field requiring experienced endoscopists.
• Optimal patient treatment and outcomes are achieved in specialized healthcare institutions.
• The complexity of pancreatic stenting necessitates expert management for best results.