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Rev. méd. Chile ; 143(9): 1121-1128, set. 2015. ilus, tab
Artículo en Español | LILACS | ID: lil-762682

RESUMEN

Background: Intraductal stones, ductal abnormalities and pancreatic pseudocysts are part of chronic pancreatitis (CP). The goal of treatment is pain relief, resolution of local complications and relapse prevention. Endoscopic therapy (ET) can be considered in those who do not respond to medical treatment. Aim: To evaluate the indication, immediate and long-term results of ET in CP patients. Patients and Methods: Review of a database of patients with CP analyzing results of ET in 18 patients aged 16 to 60 years (13 males). Demographics, etiology, endoscopic technique, indication for treatment, pain relief, relapses and complications were recorded. Results: The etiology of CP was alcohol consumption in 5, idiopathic in 11, hereditary in one and autoimmune in one case. The follow-up period was 6 months to 14 years. Seven patients had diabetes mellitus type 3c and eight had moderate to severe exocrine pancreatic insufficiency. Pancreatic papillotomy was performed in all patients, with removal of some stones, without attempting a complete clearance of the pancreatic duct. In addition, a 7-10 French stent was placed in the main pancreatic duct in 15 patients with varying permanence (months to years). The stent was changed guided by recurrence of clinical symptoms. During the follow-up period, 10 patients remained asymptomatic and in three, pain or relapse were significantly reduced. Stenting failed in one patient for technical reasons. Two patients were operated. There were neither immediate nor late complications from ET. Conclusions: Long-lasting improvement of CP was observed in 13 of 18 patients treated with ET, without complications associated with the procedure.


Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Colangiopancreatografia Retrógrada Endoscópica/métodos , Pancreatitis Crónica/cirugía , Dolor Abdominal/etiología , Dolor Abdominal/terapia , Consumo de Bebidas Alcohólicas/efectos adversos , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Estudios de Seguimiento , Dolor Postoperatorio , Pancreatitis Crónica/complicaciones , Periodo Posoperatorio , Recurrencia , Estudios Retrospectivos , Esfinterotomía Endoscópica/efectos adversos , Esfinterotomía Endoscópica/métodos , Stents/efectos adversos , Resultado del Tratamiento
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