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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_66_библиотеки_им_акад_М_И_Перельмана
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Q.What are the indications of biliary Drainage in Chronic Pancreatitis?
1. Symptomatic cholangitis
2. Biliary cirrhosis (Biopsy proven)
3. CBD stones along with CBD stricture
4. Progression of CBD stricture based on radiology
5. Persistent jaundice>1 month
6. Persistent raised ALP (3XULN)>1 month (Abdullah etal., HPBS 2007)
Q.What are the options for the management of biliary obstruction in CP?
Endoscopic intervention, either using multiple plastic stents (MPS) or a fully cov-
ered self-expanding metal stent (FCSEMS), are available modalities for managing
biliary obstruction secondary to stricture in CP.
A previous study showed that a 6-month treatment with either multiple 10-Fr
plastic stents or one 10-mm SEMS produces good long-term relief of biliary stric-
ture caused by chronic pancreatitis (Haapamäki etal. Endoscopy 2014). Another
recent trial has shown that endotherapy with multiple plastic stents provides similar
efcacy and safety for 12-month treatment as single FCSEMS, with FCSEMS
requiring fewer ERCPs over 2 years (Ramchandani etal. Gastroenterology 2021).
Further Reading
Gardner TB, etal. ACG clinical guideline: chronic pancreatitis. ACG. 2020;115(3):322–39.
23 Chronic Pancreatitis
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