Endoscopic treatment of chronic pancreatitis: a multicenter study of 1000 patients with long-term follow-up

Endoscopy. 2002 Oct;34(10):765-71. doi: 10.1055/s-2002-34256.


Background and study aims: Endoscopic ductal decompression therapy has become an established method of treating patients with painful obstructive chronic pancreatitis. Smaller series, mostly with a medium-term follow-up period, have reported encouraging results. The present analysis presents long-term follow-up data from a large multicenter patient cohort.

Patients and methods: Patients with painful chronic pancreatitis and with ductal obstruction due to either strictures and/or stones treated endoscopically at eight different centers underwent follow-up after 2 - 12 years (mean 4.9 years). The patients' clinical data, the rate of technical success, and complications were recorded from the charts. Follow-up data were prospectively obtained using structured questionnaires; the main parameter for evaluating treatment success was a significant reduction in pain (no pain or only weak pain).

Results: Follow-up data were obtained from 1018 of 1211 patients treated (84%) with mainly strictures (47%), stones (18%), or strictures plus stones (32%). At the long-term follow-up, 60% of the patients had their endotherapy completed, 16% were still receiving some form of endoscopic treatment, and 24% had undergone surgery. The long-term success of endotherapy was 86% in the entire group, but only 65% in an intention-to-treat analysis. There were no significant differences between the patient groups with regard to either strictures, stones, or both. Pancreatic function was not positively affected by endoscopic therapy.

Conclusions: Endoscopic ductal decompression therapy offers relief of pain in two-thirds of the patients when it is used as the only form of treatment. One-quarter of the patients have to undergo surgery.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Cholangiopancreatography, Endoscopic Retrograde*
  • Chronic Disease
  • Decompression, Surgical
  • Drainage
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain Management
  • Pancreatic Ducts / physiopathology
  • Pancreatic Ducts / surgery*
  • Pancreatitis / physiopathology
  • Pancreatitis / surgery*