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Erschienen in: Digestive Diseases and Sciences 7/2017

03.03.2017 | Review

Endoscopic Therapies for Chronic Pancreatitis

verfasst von: Jeffrey M. Adler, Timothy B. Gardner

Erschienen in: Digestive Diseases and Sciences | Ausgabe 7/2017

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Abstract

Chronic pancreatitis is a fibroinflammatory disease of the pancreas leading to varying degrees of endocrine and exocrine dysfunction. Treatment options are generally designed to control the pain of chronic pancreatitis, and endoscopic therapy is one of the main treatment modalities. Herein, we describe the endoscopic management of pancreatic duct calculi and strictures, entrapment of the intrapancreatic bile duct, celiac plexus interventions, and drainage of pancreatic pseudocysts.
Literatur
1.
3.
Zurück zum Zitat Hall TC, Garcea G, Webb MA, Al-Leswas D, Metcalfe MS, Dennison AR. The socio-economic impact of chronic pancreatitis: A systematic review. J Eval Clin Pract. 2014;20:203–207. doi:10.1111/jep.12117.CrossRefPubMed Hall TC, Garcea G, Webb MA, Al-Leswas D, Metcalfe MS, Dennison AR. The socio-economic impact of chronic pancreatitis: A systematic review. J Eval Clin Pract. 2014;20:203–207. doi:10.​1111/​jep.​12117.CrossRefPubMed
6.
Zurück zum Zitat Smits ME, Rauws EA, Tytgat GN, Huibregtse K. Endoscopic treatment of pancreatic stones in patients with chronic pancreatitis. Gastrointest Endosc. 1996;43:556–560.CrossRefPubMed Smits ME, Rauws EA, Tytgat GN, Huibregtse K. Endoscopic treatment of pancreatic stones in patients with chronic pancreatitis. Gastrointest Endosc. 1996;43:556–560.CrossRefPubMed
7.
Zurück zum Zitat Sherman S, Lehman GA, Hawes RH, et al. Pancreatic ductal stones: Frequency of successful endoscopic removal and improvement in symptoms. Gastrointest Endosc. 1991;37:511–517.CrossRefPubMed Sherman S, Lehman GA, Hawes RH, et al. Pancreatic ductal stones: Frequency of successful endoscopic removal and improvement in symptoms. Gastrointest Endosc. 1991;37:511–517.CrossRefPubMed
10.
Zurück zum Zitat Thomas M, Howell DA, Carr-Locke D, et al. Mechanical lithotripsy of pancreatic and biliary stones: Complications and available treatment options collected from expert centers. Am J Gastroenterol. 2007;102:1896–1902.CrossRefPubMed Thomas M, Howell DA, Carr-Locke D, et al. Mechanical lithotripsy of pancreatic and biliary stones: Complications and available treatment options collected from expert centers. Am J Gastroenterol. 2007;102:1896–1902.CrossRefPubMed
11.
Zurück zum Zitat Papachristou GI, Baron TH. Endoscopic treatment of an impacted pancreatic duct stone using a balloon catheter for electrohydraulic lithotripsy without pancreatoscopy. J Clin Gastroenterol. 2006;40:753–756.CrossRefPubMed Papachristou GI, Baron TH. Endoscopic treatment of an impacted pancreatic duct stone using a balloon catheter for electrohydraulic lithotripsy without pancreatoscopy. J Clin Gastroenterol. 2006;40:753–756.CrossRefPubMed
12.
Zurück zum Zitat Maydeo A, Kwek BE, Bhandari S, Bapat M, Dhir V. Single-operator cholangioscopy-guided laser lithotripsy in patients with difficult biliary and pancreatic ductal stones (with videos). Gastrointest Endosc. 2011;74:1308–1314. doi:10.1016/j.gie.2011.08.047.CrossRefPubMed Maydeo A, Kwek BE, Bhandari S, Bapat M, Dhir V. Single-operator cholangioscopy-guided laser lithotripsy in patients with difficult biliary and pancreatic ductal stones (with videos). Gastrointest Endosc. 2011;74:1308–1314. doi:10.​1016/​j.​gie.​2011.​08.​047.CrossRefPubMed
13.
14.
Zurück zum Zitat Dumonceau JM, Costamagna G, Tringali A, et al. Treatment for painful calcified chronic pancreatitis: Extracorporeal shock wave lithotripsy versus endoscopic treatment: A randomised controlled trial. Gut. 2007;56:545–552.CrossRefPubMed Dumonceau JM, Costamagna G, Tringali A, et al. Treatment for painful calcified chronic pancreatitis: Extracorporeal shock wave lithotripsy versus endoscopic treatment: A randomised controlled trial. Gut. 2007;56:545–552.CrossRefPubMed
15.
16.
Zurück zum Zitat Farnbacher MJ, Schoen C, Rabenstein T, Benninger J, Hahn EG, Schneider HT. Pancreatic duct stones in chronic pancreatitis: Criteria for treatment intensity and success. Gastrointest Endosc. 2002;56:501–506. doi:10.1067/mge.2002.128162.CrossRefPubMed Farnbacher MJ, Schoen C, Rabenstein T, Benninger J, Hahn EG, Schneider HT. Pancreatic duct stones in chronic pancreatitis: Criteria for treatment intensity and success. Gastrointest Endosc. 2002;56:501–506. doi:10.​1067/​mge.​2002.​128162.CrossRefPubMed
17.
Zurück zum Zitat Dumonceau JM, Delhaye M, Tringali A, et al. Endoscopic treatment of chronic pancreatitis: European society of gastrointestinal endoscopy (ESGE) clinical guideline. Endoscopy. 2012;44:784–800. doi:10.1055/s-0032-1309840.CrossRefPubMed Dumonceau JM, Delhaye M, Tringali A, et al. Endoscopic treatment of chronic pancreatitis: European society of gastrointestinal endoscopy (ESGE) clinical guideline. Endoscopy. 2012;44:784–800. doi:10.​1055/​s-0032-1309840.CrossRefPubMed
19.
Zurück zum Zitat Inui K, Tazuma S, Yamaguchi T, et al. Treatment of pancreatic stones with extracorporeal shock wave lithotripsy: Results of a multicenter survey. Pancreas. 2005;30:26–30.PubMed Inui K, Tazuma S, Yamaguchi T, et al. Treatment of pancreatic stones with extracorporeal shock wave lithotripsy: Results of a multicenter survey. Pancreas. 2005;30:26–30.PubMed
20.
Zurück zum Zitat Ohara H, Hoshino M, Hayakawa T, et al. Single application extracorporeal shock wave lithotripsy is the first choice for patients with pancreatic duct stones. Am J Gastroenterol. 1996;91:1388–1394.PubMed Ohara H, Hoshino M, Hayakawa T, et al. Single application extracorporeal shock wave lithotripsy is the first choice for patients with pancreatic duct stones. Am J Gastroenterol. 1996;91:1388–1394.PubMed
21.
Zurück zum Zitat Moole H, Jaeger A, Bechtold ML, Forcione D, Taneja D, Puli SR. Success of extracorporeal shock wave lithotripsy in chronic calcific pancreatitis management: A meta-analysis and systematic review. Pancreas. 2016;45:651–658. doi:10.1097/MPA.0000000000000512.CrossRefPubMed Moole H, Jaeger A, Bechtold ML, Forcione D, Taneja D, Puli SR. Success of extracorporeal shock wave lithotripsy in chronic calcific pancreatitis management: A meta-analysis and systematic review. Pancreas. 2016;45:651–658. doi:10.​1097/​MPA.​0000000000000512​.CrossRefPubMed
22.
Zurück zum Zitat Guda NM, Freeman ML, Smith C. Role of extracorporeal shock wave lithotripsy in the treatment of pancreatic stones. Rev Gastroenterol Disord. 2005;5:73–81.PubMed Guda NM, Freeman ML, Smith C. Role of extracorporeal shock wave lithotripsy in the treatment of pancreatic stones. Rev Gastroenterol Disord. 2005;5:73–81.PubMed
23.
Zurück zum Zitat Seven G, Schreiner MA, Ross AS, et al. Long-term outcomes associated with pancreatic extracorporeal shock wave lithotripsy for chronic calcific pancreatitis. Gastrointest Endosc. 2012;75:997.e1–1004.e1. doi:10.1016/j.gie.2012.01.014.CrossRef Seven G, Schreiner MA, Ross AS, et al. Long-term outcomes associated with pancreatic extracorporeal shock wave lithotripsy for chronic calcific pancreatitis. Gastrointest Endosc. 2012;75:997.e1–1004.e1. doi:10.​1016/​j.​gie.​2012.​01.​014.CrossRef
25.
26.
Zurück zum Zitat Adler DG, Lichtenstein D, Baron TH, et al. The role of endoscopy in patients with chronic pancreatitis. Gastrointest Endosc. 2006;63:933–937.CrossRefPubMed Adler DG, Lichtenstein D, Baron TH, et al. The role of endoscopy in patients with chronic pancreatitis. Gastrointest Endosc. 2006;63:933–937.CrossRefPubMed
27.
Zurück zum Zitat Ponchon T, Bory RM, Hedelius F, et al. Endoscopic stenting for pain relief in chronic pancreatitis: Results of a standardized protocol. Gastrointest Endosc. 1995;42:452–456.CrossRefPubMed Ponchon T, Bory RM, Hedelius F, et al. Endoscopic stenting for pain relief in chronic pancreatitis: Results of a standardized protocol. Gastrointest Endosc. 1995;42:452–456.CrossRefPubMed
28.
Zurück zum Zitat Smits ME, Badiga SM, Rauws EA, Tytgat GN, Huibregtse K. Long-term results of pancreatic stents in chronic pancreatitis. Gastrointest Endosc. 1995;42:461–467.CrossRefPubMed Smits ME, Badiga SM, Rauws EA, Tytgat GN, Huibregtse K. Long-term results of pancreatic stents in chronic pancreatitis. Gastrointest Endosc. 1995;42:461–467.CrossRefPubMed
32.
Zurück zum Zitat Binmoeller KF, Jue P, Seifert H, Nam WC, Izbicki J, Soehendra N. Endoscopic pancreatic stent drainage in chronic pancreatitis and a dominant stricture: Long-term results. Endoscopy. 1995;27:638–644. doi:10.1055/s-2007-1005780.CrossRefPubMed Binmoeller KF, Jue P, Seifert H, Nam WC, Izbicki J, Soehendra N. Endoscopic pancreatic stent drainage in chronic pancreatitis and a dominant stricture: Long-term results. Endoscopy. 1995;27:638–644. doi:10.​1055/​s-2007-1005780.CrossRefPubMed
34.
Zurück zum Zitat Costamagna G, Bulajic M, Tringali A, et al. Multiple stenting of refractory pancreatic duct strictures in severe chronic pancreatitis: Long-term results. Endoscopy. 2006;38:254–259. doi:10.1055/s-2005-921069.CrossRefPubMed Costamagna G, Bulajic M, Tringali A, et al. Multiple stenting of refractory pancreatic duct strictures in severe chronic pancreatitis: Long-term results. Endoscopy. 2006;38:254–259. doi:10.​1055/​s-2005-921069.CrossRefPubMed
35.
Zurück zum Zitat Morgan DE, Smith JK, Hawkins K, Wilcox CM. Endoscopic stent therapy in advanced chronic pancreatitis: Relationships between ductal changes, clinical response, and stent patency. Am J Gastroenterol. 2003;98:821–826.CrossRefPubMed Morgan DE, Smith JK, Hawkins K, Wilcox CM. Endoscopic stent therapy in advanced chronic pancreatitis: Relationships between ductal changes, clinical response, and stent patency. Am J Gastroenterol. 2003;98:821–826.CrossRefPubMed
36.
Zurück zum Zitat Moon SH, Kim MH, Park DH, et al. Modified fully covered self-expandable metal stents with antimigration features for benign pancreatic-duct strictures in advanced chronic pancreatitis, with a focus on the safety profile and reducing migration. Gastrointest Endosc. 2010;72:86–91. doi:10.1016/j.gie.2010.01.063.CrossRefPubMed Moon SH, Kim MH, Park DH, et al. Modified fully covered self-expandable metal stents with antimigration features for benign pancreatic-duct strictures in advanced chronic pancreatitis, with a focus on the safety profile and reducing migration. Gastrointest Endosc. 2010;72:86–91. doi:10.​1016/​j.​gie.​2010.​01.​063.CrossRefPubMed
37.
Zurück zum Zitat Andren-Sandberg A, Dervenis C. Pancreatic pseudocysts in the 21st century. Part I: Classification, pathophysiology, anatomic considerations and treatment. JOP. 2004;5:8–24.PubMed Andren-Sandberg A, Dervenis C. Pancreatic pseudocysts in the 21st century. Part I: Classification, pathophysiology, anatomic considerations and treatment. JOP. 2004;5:8–24.PubMed
38.
Zurück zum Zitat Bourliere M, Sarles H. Pancreatic cysts and pseudocysts associated with acute and chronic pancreatitis. Dig Dis Sci. 1989;34:343–348.CrossRefPubMed Bourliere M, Sarles H. Pancreatic cysts and pseudocysts associated with acute and chronic pancreatitis. Dig Dis Sci. 1989;34:343–348.CrossRefPubMed
40.
Zurück zum Zitat Gouyon B, Levy P, Ruszniewski P, et al. Predictive factors in the outcome of pseudocysts complicating alcoholic chronic pancreatitis. Gut. 1997;41:821–825.CrossRefPubMedPubMedCentral Gouyon B, Levy P, Ruszniewski P, et al. Predictive factors in the outcome of pseudocysts complicating alcoholic chronic pancreatitis. Gut. 1997;41:821–825.CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Varadarajulu S, Bang JY, Sutton BS, Trevino JM, Christein JD, Wilcox CM. Equal efficacy of endoscopic and surgical cystogastrostomy for pancreatic pseudocyst drainage in a randomized trial. Gastroenterology. 2013;145:583.e1–590.e1. doi:10.1053/j.gastro.2013.05.046.CrossRef Varadarajulu S, Bang JY, Sutton BS, Trevino JM, Christein JD, Wilcox CM. Equal efficacy of endoscopic and surgical cystogastrostomy for pancreatic pseudocyst drainage in a randomized trial. Gastroenterology. 2013;145:583.e1–590.e1. doi:10.​1053/​j.​gastro.​2013.​05.​046.CrossRef
43.
Zurück zum Zitat Varadarajulu S, Bang JY, Phadnis MA, Christein JD, Wilcox CM. Endoscopic transmural drainage of peripancreatic fluid collections: Outcomes and predictors of treatment success in 211 consecutive patients. J Gastrointest Surg. 2011;15:2080–2088. doi:10.1007/s11605-011-1621-8.CrossRefPubMed Varadarajulu S, Bang JY, Phadnis MA, Christein JD, Wilcox CM. Endoscopic transmural drainage of peripancreatic fluid collections: Outcomes and predictors of treatment success in 211 consecutive patients. J Gastrointest Surg. 2011;15:2080–2088. doi:10.​1007/​s11605-011-1621-8.CrossRefPubMed
46.
Zurück zum Zitat Keane MG, Sze SF, Cieplik N, et al. Endoscopic versus percutaneous drainage of symptomatic pancreatic fluid collections: A 14-year experience from a tertiary hepatobiliary centre. Surg Endosc. 2016;30:3730–3740. doi:10.1007/s00464-015-4668-x.CrossRefPubMed Keane MG, Sze SF, Cieplik N, et al. Endoscopic versus percutaneous drainage of symptomatic pancreatic fluid collections: A 14-year experience from a tertiary hepatobiliary centre. Surg Endosc. 2016;30:3730–3740. doi:10.​1007/​s00464-015-4668-x.CrossRefPubMed
47.
Zurück zum Zitat Cahen D, Rauws E, Fockens P, Weverling G, Huibregtse K, Bruno M. Endoscopic drainage of pancreatic pseudocysts: Long-term outcome and procedural factors associated with safe and successful treatment. Endoscopy. 2005;37:977–983. doi:10.1055/s-2005-870336.CrossRefPubMed Cahen D, Rauws E, Fockens P, Weverling G, Huibregtse K, Bruno M. Endoscopic drainage of pancreatic pseudocysts: Long-term outcome and procedural factors associated with safe and successful treatment. Endoscopy. 2005;37:977–983. doi:10.​1055/​s-2005-870336.CrossRefPubMed
48.
Zurück zum Zitat Bang JY, Wilcox CM, Trevino JM, et al. Relationship between stent characteristics and treatment outcomes in endoscopic transmural drainage of uncomplicated pancreatic pseudocysts. Surg Endosc. 2014;28:2877–2883. doi:10.1007/s00464-014-3541-7.CrossRefPubMed Bang JY, Wilcox CM, Trevino JM, et al. Relationship between stent characteristics and treatment outcomes in endoscopic transmural drainage of uncomplicated pancreatic pseudocysts. Surg Endosc. 2014;28:2877–2883. doi:10.​1007/​s00464-014-3541-7.CrossRefPubMed
49.
Zurück zum Zitat Arvanitakis M, Delhaye M, Bali MA, et al. Pancreatic-fluid collections: A randomized controlled trial regarding stent removal after endoscopic transmural drainage. Gastrointest Endosc. 2007;65:609–619.CrossRefPubMed Arvanitakis M, Delhaye M, Bali MA, et al. Pancreatic-fluid collections: A randomized controlled trial regarding stent removal after endoscopic transmural drainage. Gastrointest Endosc. 2007;65:609–619.CrossRefPubMed
51.
Zurück zum Zitat Yang D, Amin S, Gonzalez S, et al. Transpapillary drainage has no added benefit on treatment outcomes in patients undergoing EUS-guided transmural drainage of pancreatic pseudocysts: A large multicenter study. Gastrointest Endosc. 2016;83:720–729. doi:10.1016/j.gie.2015.10.040.CrossRefPubMed Yang D, Amin S, Gonzalez S, et al. Transpapillary drainage has no added benefit on treatment outcomes in patients undergoing EUS-guided transmural drainage of pancreatic pseudocysts: A large multicenter study. Gastrointest Endosc. 2016;83:720–729. doi:10.​1016/​j.​gie.​2015.​10.​040.CrossRefPubMed
53.
Zurück zum Zitat Gress F, Schmitt C, Sherman S, Ikenberry S, Lehman G. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol. 1999;94:900–905.CrossRefPubMed Gress F, Schmitt C, Sherman S, Ikenberry S, Lehman G. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol. 1999;94:900–905.CrossRefPubMed
54.
Zurück zum Zitat Gress F, Schmitt C, Sherman S, Ciaccia D, Ikenberry S, Lehman G. Endoscopic ultrasound-guided celiac plexus block for managing abdominal pain associated with chronic pancreatitis: A prospective single center experience. Am J Gastroenterol. 2001;96:409–416.CrossRefPubMed Gress F, Schmitt C, Sherman S, Ciaccia D, Ikenberry S, Lehman G. Endoscopic ultrasound-guided celiac plexus block for managing abdominal pain associated with chronic pancreatitis: A prospective single center experience. Am J Gastroenterol. 2001;96:409–416.CrossRefPubMed
56.
Zurück zum Zitat Stevens T, Costanzo A, Lopez R, Kapural L, Parsi MA, Vargo JJ. Adding triamcinolone to endoscopic ultrasound-guided celiac plexus blockade does not reduce pain in patients with chronic pancreatitis. Clin Gastroenterol Hepatol. 2012;10:186.e1–191.e1. doi:10.1016/j.cgh.2011.09.006.CrossRef Stevens T, Costanzo A, Lopez R, Kapural L, Parsi MA, Vargo JJ. Adding triamcinolone to endoscopic ultrasound-guided celiac plexus blockade does not reduce pain in patients with chronic pancreatitis. Clin Gastroenterol Hepatol. 2012;10:186.e1–191.e1. doi:10.​1016/​j.​cgh.​2011.​09.​006.CrossRef
57.
Zurück zum Zitat Santosh D, Lakhtakia S, Gupta R, et al. Clinical trial: A randomized trial comparing fluoroscopy guided percutaneous technique vs. endoscopic ultrasound guided technique of coeliac plexus block for treatment of pain in chronic pancreatitis. Aliment Pharmacol Ther. 2009;29:979–984. doi:10.1111/j.1365-2036.2009.03963.x.CrossRefPubMed Santosh D, Lakhtakia S, Gupta R, et al. Clinical trial: A randomized trial comparing fluoroscopy guided percutaneous technique vs. endoscopic ultrasound guided technique of coeliac plexus block for treatment of pain in chronic pancreatitis. Aliment Pharmacol Ther. 2009;29:979–984. doi:10.​1111/​j.​1365-2036.​2009.​03963.​x.CrossRefPubMed
58.
Zurück zum Zitat Kaufman M, Singh G, Das S, et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol. 2010;44:127–134. doi:10.1097/MCG.0b013e3181bb854d.CrossRefPubMed Kaufman M, Singh G, Das S, et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol. 2010;44:127–134. doi:10.​1097/​MCG.​0b013e3181bb854d​.CrossRefPubMed
59.
Zurück zum Zitat Puli SR, Reddy JB, Bechtold ML, Antillon MR, Brugge WR. EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain: A meta-analysis and systematic review. Dig Dis Sci. 2009;54:2330–2337. doi:10.1007/s10620-008-0651-x.CrossRefPubMed Puli SR, Reddy JB, Bechtold ML, Antillon MR, Brugge WR. EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain: A meta-analysis and systematic review. Dig Dis Sci. 2009;54:2330–2337. doi:10.​1007/​s10620-008-0651-x.CrossRefPubMed
60.
Zurück zum Zitat Sey MS, Schmaltz L, Al-Haddad MA, et al. Effectiveness and safety of serial endoscopic ultrasound-guided celiac plexus block for chronic pancreatitis. Endosc Int Open. 2015;3:E56–E59. doi:10.1055/s-0034-1377919.PubMed Sey MS, Schmaltz L, Al-Haddad MA, et al. Effectiveness and safety of serial endoscopic ultrasound-guided celiac plexus block for chronic pancreatitis. Endosc Int Open. 2015;3:E56–E59. doi:10.​1055/​s-0034-1377919.PubMed
63.
Zurück zum Zitat Sand JA, Nordback IH. Management of cholestasis in patients with chronic pancreatitis: Evaluation of a treatment protocol. Eur J Surg. 1995;161:587–592.PubMed Sand JA, Nordback IH. Management of cholestasis in patients with chronic pancreatitis: Evaluation of a treatment protocol. Eur J Surg. 1995;161:587–592.PubMed
64.
Zurück zum Zitat Stahl TJ, Allen MO, Ansel HJ, Vennes JA. Partial biliary obstruction caused by chronic pancreatitis. An appraisal of indications for surgical biliary drainage. Ann Surg. 1988;207:26–32.CrossRefPubMedPubMedCentral Stahl TJ, Allen MO, Ansel HJ, Vennes JA. Partial biliary obstruction caused by chronic pancreatitis. An appraisal of indications for surgical biliary drainage. Ann Surg. 1988;207:26–32.CrossRefPubMedPubMedCentral
65.
66.
Zurück zum Zitat Frey CF, Suzuki M, Isaji S. Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. World J Surg. 1990;14:59–69.CrossRefPubMed Frey CF, Suzuki M, Isaji S. Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. World J Surg. 1990;14:59–69.CrossRefPubMed
67.
Zurück zum Zitat Arslanlar S, Jain R. Benign biliary strictures related to chronic pancreatitis: Balloons, stents, or surgery. Curr Treat Options Gastroenterol. 2007;10:369–375.CrossRefPubMed Arslanlar S, Jain R. Benign biliary strictures related to chronic pancreatitis: Balloons, stents, or surgery. Curr Treat Options Gastroenterol. 2007;10:369–375.CrossRefPubMed
69.
Zurück zum Zitat Catalano MF, Linder JD, George S, Alcocer E, Geenen JE. Treatment of symptomatic distal common bile duct stenosis secondary to chronic pancreatitis: Comparison of single vs. multiple simultaneous stents. Gastrointest Endosc. 2004;60:945–952.CrossRefPubMed Catalano MF, Linder JD, George S, Alcocer E, Geenen JE. Treatment of symptomatic distal common bile duct stenosis secondary to chronic pancreatitis: Comparison of single vs. multiple simultaneous stents. Gastrointest Endosc. 2004;60:945–952.CrossRefPubMed
70.
Zurück zum Zitat Pozsar J, Sahin P, Laszlo F, Forro G, Topa L. Medium-term results of endoscopic treatment of common bile duct strictures in chronic calcifying pancreatitis with increasing numbers of stents. J Clin Gastroenterol. 2004;38:118–123.CrossRefPubMed Pozsar J, Sahin P, Laszlo F, Forro G, Topa L. Medium-term results of endoscopic treatment of common bile duct strictures in chronic calcifying pancreatitis with increasing numbers of stents. J Clin Gastroenterol. 2004;38:118–123.CrossRefPubMed
71.
Zurück zum Zitat Lawrence C, Romagnuolo J, Payne KM, Hawes RH, Cotton PB. Low symptomatic premature stent occlusion of multiple plastic stents for benign biliary strictures: Comparing standard and prolonged stent change intervals. Gastrointest Endosc. 2010;72:558–563. doi:10.1016/j.gie.2010.05.029.CrossRefPubMed Lawrence C, Romagnuolo J, Payne KM, Hawes RH, Cotton PB. Low symptomatic premature stent occlusion of multiple plastic stents for benign biliary strictures: Comparing standard and prolonged stent change intervals. Gastrointest Endosc. 2010;72:558–563. doi:10.​1016/​j.​gie.​2010.​05.​029.CrossRefPubMed
Metadaten
Titel
Endoscopic Therapies for Chronic Pancreatitis
verfasst von
Jeffrey M. Adler
Timothy B. Gardner
Publikationsdatum
03.03.2017
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 7/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4502-5

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