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Prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis by an endoscopic pancreatic spontaneous dislodgement stent.
Clin Gastroenterol Hepatol 2007; 5(11):1339-46CG

Abstract

BACKGROUND & AIMS

Pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) is the most common and potentially serious complication of ERCP. The frequency of post-ERCP pancreatitis generally is reported to be between 1% and 9%. One cause of pancreatitis is retention of pancreatic juice resulting from papilledema after the procedure. We conducted a randomized controlled multicenter study to evaluate whether placement of a temporary pancreatic stent designed for spontaneous dislodgement prevents post-ERCP pancreatitis.

METHODS

The subjects were 201 consecutive patients who underwent ERCP. The patients were randomized into the stent placement group (S group = 98) or the nonstent placement group (nS group = 103). The stent used was 5F in diameter, 3 cm in length, straight, and unflanged inside.

RESULTS

Stents were placed successfully in 96% of the S group, and spontaneous stent dislodgment was recognized in 95.7% of those. The mean duration to dislodgment was 2 days, and there were no severe complications. The overall frequency of post-ERCP pancreatitis was 8.5%. The frequency of post-ERCP pancreatitis in the S and nS groups was 3.2% and 13.6%, respectively, showing a significantly lower frequency in the S group (P = .019). The mean increase in amylase level in the pancreatitis patients was significantly higher in the nS group (P = .014).

CONCLUSIONS

The randomized controlled multicenter trial showed that placement of a pancreatic spontaneous dislodgment stent significantly reduces post-ERCP pancreatitis.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan. a-sofuni@amy.hi-ho.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

17981247

Citation

Sofuni, Atsushi, et al. "Prophylaxis of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis By an Endoscopic Pancreatic Spontaneous Dislodgement Stent." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 5, no. 11, 2007, pp. 1339-46.
Sofuni A, Maguchi H, Itoi T, et al. Prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis by an endoscopic pancreatic spontaneous dislodgement stent. Clin Gastroenterol Hepatol. 2007;5(11):1339-46.
Sofuni, A., Maguchi, H., Itoi, T., Katanuma, A., Hisai, H., Niido, T., ... Takada, T. (2007). Prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis by an endoscopic pancreatic spontaneous dislodgement stent. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 5(11), pp. 1339-46.
Sofuni A, et al. Prophylaxis of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis By an Endoscopic Pancreatic Spontaneous Dislodgement Stent. Clin Gastroenterol Hepatol. 2007;5(11):1339-46. PubMed PMID: 17981247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis by an endoscopic pancreatic spontaneous dislodgement stent. AU - Sofuni,Atsushi, AU - Maguchi,Hiroyuki, AU - Itoi,Takao, AU - Katanuma,Akio, AU - Hisai,Hiroyuki, AU - Niido,Teitetsu, AU - Toyota,Masayuki, AU - Fujii,Tsuneshi, AU - Harada,Youji, AU - Takada,Tadanori, PY - 2007/11/6/pubmed PY - 2007/12/14/medline PY - 2007/11/6/entrez SP - 1339 EP - 46 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 5 IS - 11 N2 - BACKGROUND & AIMS: Pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) is the most common and potentially serious complication of ERCP. The frequency of post-ERCP pancreatitis generally is reported to be between 1% and 9%. One cause of pancreatitis is retention of pancreatic juice resulting from papilledema after the procedure. We conducted a randomized controlled multicenter study to evaluate whether placement of a temporary pancreatic stent designed for spontaneous dislodgement prevents post-ERCP pancreatitis. METHODS: The subjects were 201 consecutive patients who underwent ERCP. The patients were randomized into the stent placement group (S group = 98) or the nonstent placement group (nS group = 103). The stent used was 5F in diameter, 3 cm in length, straight, and unflanged inside. RESULTS: Stents were placed successfully in 96% of the S group, and spontaneous stent dislodgment was recognized in 95.7% of those. The mean duration to dislodgment was 2 days, and there were no severe complications. The overall frequency of post-ERCP pancreatitis was 8.5%. The frequency of post-ERCP pancreatitis in the S and nS groups was 3.2% and 13.6%, respectively, showing a significantly lower frequency in the S group (P = .019). The mean increase in amylase level in the pancreatitis patients was significantly higher in the nS group (P = .014). CONCLUSIONS: The randomized controlled multicenter trial showed that placement of a pancreatic spontaneous dislodgment stent significantly reduces post-ERCP pancreatitis. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/17981247/Prophylaxis_of_post_endoscopic_retrograde_cholangiopancreatography_pancreatitis_by_an_endoscopic_pancreatic_spontaneous_dislodgement_stent_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(07)00711-2 DB - PRIME DP - Unbound Medicine ER -