- Volume 15 Issue 16
DOI QR Code
Clinical Efficacy of Endoscopic Pancreatic Drainage for Pain Relief with Malignant Pancreatic Duct Obstruction
- Gao, Fei (Department of endoscope, the General Hospital of Shenyang Military Region) ;
- Ma, Shuren (Department of endoscope, the General Hospital of Shenyang Military Region) ;
- Zhang, Ning (Department of endoscope, the General Hospital of Shenyang Military Region) ;
- Zhang, Yingchun (Department of endoscope, the General Hospital of Shenyang Military Region) ;
- Ai, Meina (Department of endoscope, the General Hospital of Shenyang Military Region) ;
- Wang, Bing (Department of Medical Administration, the General Hospital of Shenyang Military Region)
- Published : 2014.08.30
Objective: This study was conducted to investigate the efficacy of pancreatic drainage for pain relief in advanced pancreatic cancer. Method: Seventy-one patients with pancreatic carcinoma were divided into two groups: dilated and non-dilated pancreatic ducts. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP), endoscopic biliary stenting and pancreatic stenting. Visual Analog Scale (VAS) scores, pain remission rates and survival time were evaluated during follow-up. Results: The post-ERCP VAS score of the dilated group was lower than that of the non-dilated group at 1 and 3 months post-ERCP. There was no difference at 6 months. The pain remission rate in the dilated duct group was significantly higher than that in non-dilated duct group in 1 and 3 months post-ERCP. The median survival times were 8.17 and 8.22 months respectively. Conclusion: Endoscopic pancreatic drainage can relieve pain of advanced pancreatic cancer accompanied by safe dilation of the pancreatic duct.
Pancreatic cancer;ERCP;pancreatic drainage;pain relief
Supported by : China Postdoctoral Science Foundation
- Adams MA, Anderson MA, Myles JD, Khalatbari S, Scheiman JM (2012). Self-expanding metal stents (SEMS) provide superior outcomes compared to plastic stents for pancreatic cancer patients undergoing neoadjuvant therapy. J Gastrointest Oncol, 3, 309-13.
- Chen WQ, Liang D, Zhang SW, Zheng RS, He YT (2013). Pancreatic cancer incidence and mortality patterns in China, 2009. Asian Pac J Cancer Prev, 14, 7321-4. https://doi.org/10.7314/APJCP.2013.14.12.7321
- Choudhary A, Bechtold ML, Arif M, et al (2011). Pancreatic stents for prophylaxis against post-ERCP pancreatitis: a meta-analysis and systematic review. Gastrointest Endosc, 73, 275-82. https://doi.org/10.1016/j.gie.2010.10.039
- Decker C, Christein JD, Phadnis MA, Wilcox CM, Varadarajulu S (2011). Biliary metal stents are superior to plastic stents for preoperative biliary decompression in pancreatic cancer. Surg Endosc, 25, 2364-7. https://doi.org/10.1007/s00464-010-1552-6
- Huggett MT, Pereira SP (2011). Diagnosing and managing pancreatic cancer. Practitioner, 255, 21-5.
- Kruse EJ (2010). Palliation in pancreatic cancer. Surg Clin North Am, 90, 355-64. https://doi.org/10.1016/j.suc.2009.12.004
- Lee TH, Moon JH, Choi HJ, et al (2012). Prophylactic temporary 3F pancreatic duct stent to prevent post-ERCP pancreatitis in patients with a difficult biliary cannulation: a multicenter, prospective, randomized study. Gastrointest Endosc, 76, 578-85. https://doi.org/10.1016/j.gie.2012.05.001
- Lee V, Cheng H, Li G, Saif MW (2012). Quality of life in patients with pancreatic cancer. JOP, 13, 182-4.
- Maosheng D, Ohtsuka T, Ohuchida J, et al (2001). Surgical bypass versus metallic stent for unresectable pancreatic cancer. J Hepatobiliary Pancreat Surg, 8, 367-73. https://doi.org/10.1007/s005340170010
- Mazaki T, Mado K, Masuda H, Shiono M (2014). Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis. J Gastroenterol, 49, 343-55. https://doi.org/10.1007/s00535-013-0806-1
- Mazaki T, Masuda H, Takayama T (2010). Prophylactic pancreatic stent placement and post-ERCP pancreatitis: a systematic review and meta-analysis. Endoscopy, 42, 842-53. https://doi.org/10.1055/s-0030-1255781
- Saif MW (2011). Pancreatic neoplasm in 2011: an update. JOP, 12, 316-21.
- Salehimarzijarani B, Dadvar Z, Mousavi M, et al (2012). Risk factors for post-ERCP cholangitis in patients with pancreatic cancer from a single referral center in Iran. Asian Pac J Cancer Prev, 13, 1539-41. https://doi.org/10.7314/APJCP.2012.13.4.1539
- Uomo I (2011). Pain in pancreatic cancer: does drug treatment still play a role? JOP, 12, 435-7.
- Wang K, Chen Z, Meng Z, et al (2011). Analgesic effect of high intensity focused ultrasound therapy for unresectable pancreatic cancer. Int J Hyperthermia, 27, 101-7. https://doi.org/10.3109/02656736.2010.525588
- Wehrmann T, Riphaus A, Frenz MB, Martchenko K, Stergiou N (2005). Endoscopic pancreatic duct stenting for relief of pancreatic cancer pain. Eur J Gastroenterol Hepatol, 17, 1395-400. https://doi.org/10.1097/00042737-200512000-00020
- Wyse JM, Carone M, Paquin SC, Usatii M, Sahai AV (2011). Randomized, double-blind, controlled trial of early endoscopic ultrasound-guided celiac plexus neurolysis to prevent pain progression in patients with newly diagnosed, painful, inoperable pancreatic cancer. J Clin Oncol, 29, 3541-6. https://doi.org/10.1200/JCO.2010.32.2750
- Zhou W, Li Y, Zhang Q, et al (2011). Risk factors for postendoscopic retrograde cholangiopancreatography pancreatitis: a retrospective analysis of 7, 168 cases. Pancreatology, 11, 399-405. https://doi.org/10.1016/S1424-3903(11)80094-3
- Obstructive pancreatitis secondary to a pancreatic metastasis from lung cancer treated with nasopancreatic drainage pp.1865-7265, 2019, https://doi.org/10.1007/s12328-019-00944-4