Histologic changes after stenting of the pancreatic duct
C. Alvarez, M. Robert, S. Sherman and H. A. Reber
Department of Surgery, University of California-Los Angeles School of Medicine.
The placement of stents has been proposed as a possible modality to treat
pancreatic diseases. Ductal changes observed on endoscopic retrograde
cholangiopancreatography during stenting are believed to be reversible when
the stents are removed. We describe a patient with normal anatomy on
baseline pancreatograms who underwent endoscopic sphincterotomy, followed
by stent placement for 9 months. Symptoms progressed, leading to a
pancreaticoduodenectomy. Histologic evaluation of the head of the pancreas
revealed more extensive inflammatory changes in the duct and parenchyma
drained by the stent. This suggests that stent-induced changes noted on
pancreatography correspond to parenchymal changes that may be severe and
irreversible.
