The usefulness of endoscopic retrograde cholangiopancreatography in treatment of patients with chronic pancreatitis

Introduction: Chronic pancreatitis is an inflammatory condition characterized by progressing destruction of the exocrine and endocrine pancreatic tissue. Endoscopic retrograde cholangiopancreatography (ERCP) is useful in the diagnosis and treatment of chronic pancreatitis complications, like pancreatic pseudocysts and Wirsung and bile duct strictures. Aim: The aim of the study was to evaluate the therapeutic efficacy and safety of endoscopic retrograde cholangiopancreatography in patients with chronic pancreatitis. Material and methods: The retrospective analysis of 821 ERCP in the Department of Digestive Tract Diseases, Medical University of Lodz between 2005 and 2007 has been performed. Fifty patients (37 men and 13 women) who underwent endoscopic treatment for chronic pancreatitis were reviewed. We have analyzed patients demographic data, clinical symptoms, efficacy and safety of endoscopic procedures and laboratory findings before and after ERCP Results: In 38 patients (74%) pancreatic or/and biliary stents were inserted, replaced or removed. In 12 patients ERCP was performed more than once. Endoscopic pseudocyst drainage was performed in 8 cases (16%) - 5 transpapillary drainage, 3 cystogastro- or cystocluodenostomy. Finally after endoscopic procedures pain relief was achieved in 92% patients and laboratory findings were normalized. One patient (2%) required surgical treatment after ineffective endoscopic drainage of pseudocyst. In majority of patients no complications and no mortality after ERCP were noticed. In one patient haemorrhage after sphincterotomy occurred. In analyzed interval, none of the patients required surgical intervention because of ERCP complications. Conclusions: Endoscopic retrograde cholangiopancreatography is a safe and effective method in treatment on pain, cholestasis and pseudocysts in patients with chronic pancreatitis.