Pancreatic Stents: Indications, Procedure, and Outcomes

A pancreatic stent is a small tube (plastic or metal) placed endoscopically (ERCP) or percutaneously into the pancreatic duct to maintain patency and drainage.

Indications

• Pancreatitis: Acute recurrent or chronic with dominant stricture/stone; stent relieves ductal hypertension.
• Pseudocyst: Transmural or transpapillary drainage of symptomatic pseudocysts.
• Pancreatic duct obstruction: Benign strictures, postoperative leaks, sphincter of Oddi dysfunction.
• Malignant obstruction: Palliation for unresectable pancreatic cancer (biliary + pancreatic stents often placed together).
• Post-ERCP pancreatitis prophylaxis: Temporary stent reduces incidence in high-risk patients.

Stent Types

• Plastic (polyethylene): 3–11.5 Fr; temporary (weeks–months); prone to occlusion; low cost.
• Fully covered self-expanding metal stents (FCSEMS): Larger diameter, longer patency; removable; used for benign strictures, leaks, pseudocysts.
• Uncovered metal: Permanent; for malignant obstruction only.

Complications

• Migration, occlusion, ductal injury, pancreatitis, infection, stent fracture.
• Plastic stents usually exchanged every 3–6 months if long-term needed.

Clinical success: symptom relief, duct drainage on imaging, stricture resolution. Multidisciplinary pancreaticobiliary team recommended.