Strategy of Endoscopic Pancreatic Duct Drainage for Recurrent Chronic Pancreatitis

Recurrent chronic obstructive pancreatitis is attributed to pancreatic flow obstruction caused by PD stenosis, pancreatolithiasis, pancreas divisum, etc., and the consequent increased internal pressure in the caudal PD [1-3]. Methods of PD decompression include surgical procedures, such as pancreatectomy and pancreaticojejunostomy, as well as endoscopic PD stenting combined with extracorporeal shock wave lithotripsy (ESWL). Previous reports showed favorable results of PD stenting, with success rates of 72-100% and symptom relief rates of 65–87% [4-11]. At present, minimally invasive endoscopic therapy is widely employed [12]. However, prospective randomized controlled trials comparing endoscopic therapy and surgical drainage have been conducted and shown surgical drainage to be more effective [13,14]. Further studies are needed for optimal selection of therapeutic methods.