Pancreatic endotherapy improves quality of life in patients with chronic pancreatitis: Study

A new study published in the journal of Gastrointestinal Endoscopy showed that for some individuals with chronic pancreatitis (CP), pancreatic endotherapy (PET) can improve quality of life and reduce discomfort. The primary symptom of chronic pancreatitis, pain, is still challenging to successfully manage and can considerably lower a patient’s quality of life. The mechanism of pain is probably influenced by a number of factors, such as inflammation, ductal hypertension, or neuropathic pain resulting from different levels of nervous system sensitization.

The patients with CP-related structural problems, such as pancreatic duct (PD) stones, strictures, stones, or pancreatic fluid collections, such pseudocysts, may benefit from pancreatic endotherapy. Pancreatic duct stones, strictures, and pancreatic fluid collections are among the structural problems associated with chronic pancreatitis that can be managed with pancreatic endotherapy. However, the majority of research on endotherapy has been on technical success outcomes such stricture resolution or stone removal. Thus, this review is to describe in detail how PET affects the quality of life of CP patients.

A validated CP-specific quality of life instrument (PANQOLI) was used in this single-center prospective trial to evaluate quality of life prior to the start of endotherapy. At 1, 3, 6, and 12 months of follow-up, quality of life, pain levels, and opiate use were also assessed. Celiac plexus block (EUS-CPB), EUS-guided pseudocyst drainage, PD stone lithotripsy, and therapeutic PD stent insertion were among the PET modalities. At each follow-up point, quality of life changes before and after PET were compared using a repeated measures mixed effects model.

In all, 120 CP subjects were involved in this investigation. The most common PET modalities were EUS-CPB (32.5%), PD stone lithotripsy (16.7%), and therapeutic PD stenting (49.2%). At 1, 3, 6, and 12 months after completing the PET, there were notable improvements in quality of life scores, with the biggest improvement occurring at 6 months.

At the 1- and 6-month follow-ups, there were notable reductions in pain levels; but, at the 12-month follow-up, there were none. Opiate use decreased at every follow-up point. Despite pancreatic endotherapy has been linked to improvements in quality of life for up to a year after treatment, pain relief was only observed 6 months after treatment which indicates the difficulty of managing pain in this challenging patient population. 

Source:

Han, S., Rueb, N., Nikahd, M., Pessorrusso, F., Wani, S., Edmundowicz, S. A., Duloy, A., Hammad, H. T., & Shah, R. J. (2024). The Impact of Pancreatic Endotherapy on Quality of Life in Chronic Pancreatitis. In Gastrointestinal Endoscopy. Elsevier BV. https://doi.org/10.1016/j.gie.2024.12.002