Histologic changes after stenting of the pancreatic duct

The placement of stents has been proposed as a possible modality to treat pancreatic diseases. Ductal changes observed on endoscopic retrograde cholangiopancreatography during stenting are believed to be reversible when the stents are removed. We describe a patient with normal anatomy on baseline pancreatograms who underwent endoscopic sphincterotomy, followed by stent placement for 9 months. Symptoms progressed, leading to a pancreaticoduodenectomy. Histologic evaluation of the head of the pancreas revealed more extensive inflammatory changes in the duct and parenchyma drained by the stent. This suggests that stent-induced changes noted on pancreatography correspond to parenchymal changes that may be severe and irreversible.