Endoscopic pancreatic sphincterotomy (EPS) has been touted as effective therapy for several disorders including chronic pancreatitis and unexplained abdominal pain associated with pancreatic sphincter dysfunction. Although short-term data are encouraging, there are no reports on how these patients fare beyond the first few months after EPS. Methods: We reviewed the data on all patients who had EPS performed at our institution over a 4 year period between August 1992 and November 1996. Patients were then contacted by a physician other than the original endoscopist and asked to rate their pain before EPS and at follow-up. A linear pain scale score (0-10 where 10 is the worse possible pain) was used for this purpose with clinical improvement defined as a >50% reduction in the pain score Results: The data on 55 patients were available for review. There were 17 males and 38 females (mean age 43.6 ± 16.7 years). Indications for EPS included 1) chronic pancreatitis [n=40] 2) unexplained abdominal pain with pancreatic sphincter dysfunction (pSOD) [n=15]. EPS was associated with pancreatitis in 5 patients (9%), bleeding in 2 (3.6%) and early stent occlusion in 5 (9%). 7 patients had surgical sphincteroplasty after EPS. No patient died from EPS. After a median follow-up of 16 months (the longest being 52 months) 60% of all patients were improved, with an overall improvement in pain scores (3.6 ± 3.4 vs. 8.8 ± 1.8 pre-EPS; P< 0.0001). The response rate was even more impressive in the pSOD group with 73% of the patients reporting improvement and a reduction in mean pain scores from 9.0 ± 1.6 to 2.9 ± 3.3 after sphincter ablation (P < 0.001). Conclusions: In a subgroup of patients with pancreatic disease and pancreatic sphincter dysfunction, EPS results in significant clinical improvement that may be sustained for several years.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging