Clinical analysis and treatment strategy of ten cases of pancreatic duct stent displacement complicated with acute pancreatitis / 中华消化杂志

ABSTRACT

Objective To investigate clinical features and treatment strategy for pancreatic duct stent displacement complicated with acute pancreatitis.Methods Ten cases of pancreatic duct stent displacement complicated with acute pancreatitis were retrospectively analyzed.All the cases were confirmed by lab examination,X-ray examination,endoscopy and computed tomography (CT) examination.After operation,the clinical symptoms of patients were observed.Time consumed for stent removing and blood amylase level before endoscopic retrograde cholargio-pancreatography (ERCP) and 1st,4th,7th day after ERCP were recorded.Clinical features,the time of stent displacement,time of clinical cure and therapeutic strategy were summarized.Results The average age of the ten cases (four male and six female) was 55.9 years.All the displaced pancreatic duct stents were pancreatic duct stent with side wing,length five to seven cm.Obstruction was observed in one case.The end of the pancreatic duct stent of two cases dislocated at the neck of pancreats,seven cases at the head of pancreas and one at the body of pancreas.Ten cases presented with abdominal pain,seven with nausea and vomiting and one with fever.The average time of the occurrence of pancreatic duct stent displacement was 2.9 months.All the stents were successfully taken out,which of two cases were removed with balloon,seven cases with forcep and one with snare,and the average time duration was 17.7 min.After the stents taken out,pancreatic duct stent was replaced in one case and the left nine cases received nasal-pancreatic drainage treatment.After the operation,no severe complications such as pseudocyst of pancreas,pancreatic abscesses,pancreatic necrosis and gastrointestinal bleeding were observed in all the patients.Average blood amylase level at 1st,4th and 7th day after ERCP was 508 U/L,137 U/L and 86 U/L,respectively.The average time of recovery was 6.7 days,and the average time of keeping the nasal-pancreatic tube was 8.6 days.Conclusions For patients with pancreatic duct stent displacement complicated with acute pancreatitis,it is safe and effective to take out the stent and perform pancreatic duct drainage by ERCP as soon as possible,which could improve the symptoms in a short time.