Artículo de revista
Tratamiento endoscópico en la pancreatitis crónica: seguimiento a largo plazo
Fecha
2015Registro en:
Rev Med Chile 2015; 143: 1121-1128
0034-9887
Autor
Díaz, Alex
Yunge, Paola
Urzúa Manchego, Álvaro
Berger, Zoltán
Institución
Resumen
Background: Intraductal stones, ductal abnormalities and pancreatic pseudocysts
are part of chronic pancreatitis (CP). The goal of treatment is pain relief,
resolution of local complications and relapse prevention. Endoscopic therapy (ET)
can be considered in those who do not respond to medical treatment. Aim: To
evaluate the indication, immediate and long-term results of ET in CP patients.
Patients and Methods: Review of a database of patients with CP analyzing results
of ET in 18 patients aged 16 to 60 years (13 males). Demographics, etiology,
endoscopic technique, indication for treatment, pain relief, relapses and complications
were recorded. Results: The etiology of CP was alcohol consumption in 5,
idiopathic in 11, hereditary in one and autoimmune in one case. The follow-up
period was 6 months to 14 years. Seven patients had diabetes mellitus type 3c
and eight had moderate to severe exocrine pancreatic insufficiency. Pancreatic
papillotomy was performed in all patients, with removal of some stones, without
attempting a complete clearance of the pancreatic duct. In addition, a 7-10
French stent was placed in the main pancreatic duct in 15 patients with varying
permanence (months to years). The stent was changed guided by recurrence of
clinical symptoms. During the follow-up period, 10 patients remained asymptomatic
and in three, pain or relapse were significantly reduced. Stenting failed
in one patient for technical reasons. Two patients were operated. There were
neither immediate nor late complications from ET. Conclusions: Long-lasting
improvement of CP was observed in 13 of 18 patients treated with ET, without
complications associated with the procedure.