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Can pancreatic duct stenting prevent post-ERCP pancreatitis in patients who undergo pancreatic duct guidewire placement for achieving selective biliary cannulation? A prospective randomized controlled trial.
J Gastroenterol 2010; 45(11):1183-91JG

Abstract

BACKGROUND

Although pancreatic duct guidewire placement (P-GW) for achieving selective biliary cannulation is reported to be effective in patients in whom endoscopic retrograde cholangiopancreatography (ERCP) is difficult, this technique entails a possible increased risk of post-ERCP pancreatitis. We conducted a prospective randomized controlled trial to evaluate the prophylactic effect of pancreatic duct stenting on the frequency of post-ERCP pancreatitis in patients who underwent P-GW.

METHODS

Seventy patients who underwent P-GW for achieving selective biliary cannulation were included in this study. Patients were randomly assigned to either the stent group (n = 35) or the no-stent group (n = 35). The pancreatic duct stent used was a 5-Fr, 4-cm-long stent with a single pigtail at the duodenal end (Pit-stent™). The primary endpoint was the frequency of post-ERCP pancreatitis.

RESULTS

Selective biliary cannulation was achieved in 80% of the stent group and in 94% of the no-stent group (P = 0.15). Post-ERCP pancreatitis occurred in 13% (9 patients; mild). Pancreatic duct stenting was successful in 91% of the stent group. One patient in the stent group developed migration of the stent during the procedure, followed by mild pancreatitis. The frequency of post-ERCP pancreatitis in the stent group was significantly lower than that in the no-stent group (2.9 vs. 23%, relative risk 0.13, confidence interval 0.016, 0.95).

CONCLUSION

Pancreatic duct stenting after P-GW for achieving selective biliary cannulation is recommended to reduce the incidence of post-ERCP pancreatitis.

Authors+Show Affiliations

Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi, Japan. keiito@openhp.or.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
Randomized Controlled Trial

Language

eng

PubMed ID

20607310

Citation

Ito, Kei, et al. "Can Pancreatic Duct Stenting Prevent post-ERCP Pancreatitis in Patients Who Undergo Pancreatic Duct Guidewire Placement for Achieving Selective Biliary Cannulation? a Prospective Randomized Controlled Trial." Journal of Gastroenterology, vol. 45, no. 11, 2010, pp. 1183-91.
Ito K, Fujita N, Noda Y, et al. Can pancreatic duct stenting prevent post-ERCP pancreatitis in patients who undergo pancreatic duct guidewire placement for achieving selective biliary cannulation? A prospective randomized controlled trial. J Gastroenterol. 2010;45(11):1183-91.
Ito, K., Fujita, N., Noda, Y., Kobayashi, G., Obana, T., Horaguchi, J., ... Ogawa, T. (2010). Can pancreatic duct stenting prevent post-ERCP pancreatitis in patients who undergo pancreatic duct guidewire placement for achieving selective biliary cannulation? A prospective randomized controlled trial. Journal of Gastroenterology, 45(11), pp. 1183-91. doi:10.1007/s00535-010-0268-7.
Ito K, et al. Can Pancreatic Duct Stenting Prevent post-ERCP Pancreatitis in Patients Who Undergo Pancreatic Duct Guidewire Placement for Achieving Selective Biliary Cannulation? a Prospective Randomized Controlled Trial. J Gastroenterol. 2010;45(11):1183-91. PubMed PMID: 20607310.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can pancreatic duct stenting prevent post-ERCP pancreatitis in patients who undergo pancreatic duct guidewire placement for achieving selective biliary cannulation? A prospective randomized controlled trial. AU - Ito,Kei, AU - Fujita,Naotaka, AU - Noda,Yutaka, AU - Kobayashi,Go, AU - Obana,Takashi, AU - Horaguchi,Jun, AU - Takasawa,Osamu, AU - Koshita,Shinsuke, AU - Kanno,Yoshihide, AU - Ogawa,Takahisa, Y1 - 2010/07/06/ PY - 2010/04/02/received PY - 2010/05/19/accepted PY - 2010/7/8/entrez PY - 2010/7/8/pubmed PY - 2011/3/1/medline SP - 1183 EP - 91 JF - Journal of gastroenterology JO - J. Gastroenterol. VL - 45 IS - 11 N2 - BACKGROUND: Although pancreatic duct guidewire placement (P-GW) for achieving selective biliary cannulation is reported to be effective in patients in whom endoscopic retrograde cholangiopancreatography (ERCP) is difficult, this technique entails a possible increased risk of post-ERCP pancreatitis. We conducted a prospective randomized controlled trial to evaluate the prophylactic effect of pancreatic duct stenting on the frequency of post-ERCP pancreatitis in patients who underwent P-GW. METHODS: Seventy patients who underwent P-GW for achieving selective biliary cannulation were included in this study. Patients were randomly assigned to either the stent group (n = 35) or the no-stent group (n = 35). The pancreatic duct stent used was a 5-Fr, 4-cm-long stent with a single pigtail at the duodenal end (Pit-stent™). The primary endpoint was the frequency of post-ERCP pancreatitis. RESULTS: Selective biliary cannulation was achieved in 80% of the stent group and in 94% of the no-stent group (P = 0.15). Post-ERCP pancreatitis occurred in 13% (9 patients; mild). Pancreatic duct stenting was successful in 91% of the stent group. One patient in the stent group developed migration of the stent during the procedure, followed by mild pancreatitis. The frequency of post-ERCP pancreatitis in the stent group was significantly lower than that in the no-stent group (2.9 vs. 23%, relative risk 0.13, confidence interval 0.016, 0.95). CONCLUSION: Pancreatic duct stenting after P-GW for achieving selective biliary cannulation is recommended to reduce the incidence of post-ERCP pancreatitis. SN - 1435-5922 UR - https://www.unboundmedicine.com/medline/citation/20607310/Can_pancreatic_duct_stenting_prevent_post_ERCP_pancreatitis_in_patients_who_undergo_pancreatic_duct_guidewire_placement_for_achieving_selective_biliary_cannulation_A_prospective_randomized_controlled_trial_ L2 - https://dx.doi.org/10.1007/s00535-010-0268-7 DB - PRIME DP - Unbound Medicine ER -