Placement of self-expanding metallic stents in the pancreatic duct for treatment of obstructive complications of pancreatic cancer

Background: Stents have been placed through malignant pancreatic strictures, mainly to alleviate pain of presumed obstructive origin. Self-expanding metallic stents have major advantages over plastic stents when used for treatment of malignant biliary strictures. However, there are few reports of their use in patients with malignant pancreatic duct strictures, especially those with complications related to ductal obstruction. Methods: Self-expanding metallic stents were placed in the pancreatic ducts of 3 patients with obstructive complications of pancreatic cancer: smoldering pancreatitis, a disrupted pancreatic duct with pseudocyst caused by open surgical biopsy, and a disrupted pancreatic duct with fistula and resultant liver abscess. All 3 patients had metallic stents placed concomitantly in the biliary tract; one had enteral stents placed as well. Clinical and pathology records and imaging studies were reviewed retrospectively. Observations: In all cases, there was resolution of the specific clinical problem and reasonable survival (1.5 years in one patient). Conclusions: The use of self-expanding metallic stents for treatment of certain obstructive complications of pancreatic tumors is feasible and effective.