Endoscopic retrograde cholangiopancreatography (ERCP) has known as one of modality of choice for treatment of pancreatic duct (PD) stone in patients with chronic pancreatitis (CP). Although ERCP has recommended for radiolucent PD stones smaller than 5 millimeters, the management differs case by case due to PD variations and stone characteristics. This study aims to assess ERCP findings and its effects on pain improvement and quality of life in CP patients with PD stone.
In this retrospective cohort study, 47 patients with definite diagnosis of chronic pancreatitis were enrolled. Patients with history of any other pancreatic/ biliary disorders were excluded. All patients undertaken endoscopic ultrasonography (EUS) before ERCP to confirm PD stone. ERCP findings including strictures, skipped lesions and type of procedures were recorded by an expert gastroenterologist for each patient. In addition, all patients assessed for pain (using visual analog scale) and quality of life (using short form-12 questionnaire) during six months follow up. All statistical analysis was performed using SPSS version 20.
The mean age was 49.28±16.39 years and most of the patients were male 25 (54.3%). All patients had complaints of abdominal pain on admission, 9 (19.6%) of them had icter and 5 (10.6%) presented with cholangitis. 18 (39.1%) of them had history of recent weight loss. Pain significantly decreased six months after ERCP (3.91±1.47) compared to pain on admission (7.87±1.31) based on visual analog scale (P≤0.05). Furthermore, quality of life significantly improved after ERCP (27.4±5.91 vs 32.8±5.12) (P≤0.05).
The results of this study showed ERCP as a safe and effective therapeutic approach for PD stone associated with pain and quality of life improvement. However, further study is needed to compare ERCP outcomes versus surgery in management patients with PD stone.