Self-expandable metal stents safe for pancreatic duct strictures in chronic pancreatitis
Fully covered self-expandable metal stents were safe and effective for treating main pancreatic duct strictures linked to symptomatic chronic pancreatitis, according to a study published in the Journal of Gastroenterology and Hepatology.
“It would be worthwhile to carry out a prospective study comparing the efficacy, safety, removability, cost-effectiveness, and long-term outcome of the endoscopic placement of [fully covered self-expandable metal stents (FCSEMS)] with the placement of [peri-stent contrast staining (PSs)],” Ting-Ting Li, MD, from the department of gastroenterology at the West China Hospital of Sichuan University in Chengdu, China, and colleague wrote.
Researchers used Medline, Embase and ISIWeb of Science and Cochrane Library to identify 10 studies that involved 163 patients in which fully covered self-expandable metal stents were used for the management of main pancreatic duct strictures in chronic pancreatitis. Stricture resolution and recurrence rates of fully covered self-expandable metal stents were determined with meta-analysis. Investigators also calculated the crude rate of adverse events correlated with stent therapy.
Investigators found the main pancreatic duct stricture weighted pooled rate of resolution was 93% (95% CI, 84–99%) with substantial heterogeneity. Duration of stent placement more than 3 months compared with 3 months or less did not yield a significantly higher resolution rate (93% vs. 93%). The stricture recurrence weighted pooled rate was 5% (95% CI, 0–12%).
Patients with stent placement more than 3 months (3%; 95% CI, 0–10%) yielded a lower stricture recurrence rate compared with 3 months or less stent placement (7%; 95% CI, 0–23%); although not significantly different. The overall rate of adverse events correlated with stent therapy was 34.9%. Investigators noted spontaneous migration occurred in 14.1% of patients.
“Other individual adverse event rates included acute pancreatitis (8.6%), cholestasis (3.7%), and severe abdominal pain requiring stent removal (1.2%),” Li and colleagues wrote.