ENDOSCOPIC TREATMENT IN DIFFICULT TO TREAT PANCRATIC STONES AND STRICTURES

Rajesh Puri

doi:10.21767/2575-7733-C3-009

ENDOSCOPIC TREATMENT IN DIFFICULT TO TREAT PANCRATIC STONES AND STRICTURES

Annual Summit on Hepatology and Pancreatic Diseases

November 12-13, 2018 Paris, France

Rajesh Puri

M.N.A.M.S, India

Posters & Accepted Abstracts: J Clin Gastroenterol Hepatol

Abstract:

Background: There is paucity of data about endoscopic pancreatic sphincteroplasty (EPS} after endoscopic pancreatic sphincterotomy (EPST)in the treatment of chronic pancreatitis. Aims: Aim of this study was to establish the indications for endoscopic pancreatic sphincteroplasty, complications related toit andto see its effectiveness in managing chronic pancreatitis after a year of follow-up. Methods: We evaluated the safety and efficacy of the use of pancreatic balloon dilationcoupled with sphincterotomy for the treatment of chronic pancreatitis.The technicalsuccess rate of balloon dilation, stone clearance,frequency of pancreatic stenting and procedure-related adverse events were recorded. Results: Out of 736 patients who underwent pa ncreatic endotherapy betweenJuly 2014 and December 2016, there were 124 patients who underwent EPS.The meanage was 36 ± 12 years,75% (n=93) were males. (Table 1) The common indications were removal of large radiolucent stones in 48 patients;unyielding radiopaque stones post extracorporeal shock wave lithotripsy (ESWL) in 28 patients and pancreatic duct stricture combined with stones in 48 patients. EPS could be successfully completed in96 % (n-120) patients.Complete ductal clearance ina single session was achieved inonly 36 patients,while 40 patients required two sessions.A ll cases of strictures required graded dilation with a mean of 2.5 sessions (maximum 4 sessions).In four patients,stricture did not dilate adequately after 4 sessions and underwent surgery.There were fifteen adverse events of pain requiring admission for more than 24 hours andthree procedure related bleeding,all of which were ma naged conservatively.The patients had an average follow-up of 8 months (6-12 months) and allthe patients were pain free. Conclusions: Endoscopic pancreatic sphincteroplasty is a relatively safe procedure with a lowincidence of complications and a high rate of treatment success.