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Volume 356:2101-2104 May 17, 2007 Number 20
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Endoscopic versus Surgical Treatment for Chronic Pancreatitis

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by Elta, G. H.
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by Cahen, D. L.
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To the Editor: Cahen and colleagues (Feb. 15 issue)1 suggest the superiority of surgical therapy over endoscopic therapy for chronic pancreatitis and pancreatic-duct obstruction. However, the protocol for endoscopic treatment of pancreatitis and in particular the optional dilation of strictures, the frequency of stent replacement (sequential insertion every 3 months to a maximum of three stents), and the resolution of strictures on radiologic studies as the criteria for termination of endoscopic therapy may explain the disappointing rate of pain relief (32%) in the endoscopy group. Protocols that include routine stricture dilation, more frequent stent placements (every 2 months), and prolonged . . . [Full Text of this Article]



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