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Endoscopic pancreatic duct stents reduce the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients.
Clin Gastroenterol Hepatol 2011; 9(10):851-8; quiz e110CG

Abstract

BACKGROUND & AIMS

Pancreatitis is the most common and potentially serious complication of post-endoscopic retrograde cholangiopancreatography (ERCP). Post-ERCP pancreatitis (PEP) is caused mostly by postprocedural papillary edema and retention of pancreatic juice. We conducted a randomized controlled trial to determine whether placement of a temporary-type, pancreatic duct stent prevents PEP and to identify risk factors for PEP.

METHODS

We analyzed data from 426 consecutive patients who underwent ERCP-related procedures at 37 endoscopic units. The patients were assigned randomly to groups that received stents (S group, n = 213) or did not (nS group, n = 213). The stent used was temporary, 5F in diameter, 3 cm long, and straight with an unflanged inner end.

RESULTS

The overall frequency of PEP was 11.3%. The frequencies of PEP in the S and nS groups were 7.9% and 15.2%, respectively; the lower incidence of PEP in the S group was statistically significant based on the full analysis set (P = .021), although there was no statistically significant differences in an intention-to-treat analysis (P = .076). There were significant differences in PEP incidence between groups in multivariate analysis for the following risk factors: pancreatography first, nonplacement of a pancreatic duct stent after ERCP, procedure time of 30 minutes or more, sampling of pancreatic tissue by any method, intraductal ultrasonography, and difficulty of cannulation (≥15 min). Patients with more than 3 risk factors had a significantly greater incidence of pancreatitis.

CONCLUSIONS

Placement of a pancreatic duct stent reduces the incidence of PEP. Several risk factors are associated with PEP.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Tokyo Medical University, 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 availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

21749851

Citation

Sofuni, Atsushi, et al. "Endoscopic Pancreatic Duct Stents Reduce the Incidence of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in High-risk Patients." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 9, no. 10, 2011, pp. 851-8; quiz e110.
Sofuni A, Maguchi H, Mukai T, et al. Endoscopic pancreatic duct stents reduce the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients. Clin Gastroenterol Hepatol. 2011;9(10):851-8; quiz e110.
Sofuni, A., Maguchi, H., Mukai, T., Kawakami, H., Irisawa, A., Kubota, K., ... Itoi, T. (2011). Endoscopic pancreatic duct stents reduce the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 9(10), pp. 851-8; quiz e110. doi:10.1016/j.cgh.2011.06.033.
Sofuni A, et al. Endoscopic Pancreatic Duct Stents Reduce the Incidence of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis in High-risk Patients. Clin Gastroenterol Hepatol. 2011;9(10):851-8; quiz e110. PubMed PMID: 21749851.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic pancreatic duct stents reduce the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients. AU - Sofuni,Atsushi, AU - Maguchi,Hiroyuki, AU - Mukai,Tsuyoshi, AU - Kawakami,Hiroshi, AU - Irisawa,Atsushi, AU - Kubota,Kensuke, AU - Okaniwa,Shinji, AU - Kikuyama,Masataka, AU - Kutsumi,Hiromu, AU - Hanada,Keiji, AU - Ueki,Toshiharu, AU - Itoi,Takao, Y1 - 2011/07/13/ PY - 2011/01/30/received PY - 2011/06/27/revised PY - 2011/06/30/accepted PY - 2011/7/14/entrez PY - 2011/7/14/pubmed PY - 2012/1/24/medline SP - 851-8; quiz e110 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 9 IS - 10 N2 - BACKGROUND & AIMS: Pancreatitis is the most common and potentially serious complication of post-endoscopic retrograde cholangiopancreatography (ERCP). Post-ERCP pancreatitis (PEP) is caused mostly by postprocedural papillary edema and retention of pancreatic juice. We conducted a randomized controlled trial to determine whether placement of a temporary-type, pancreatic duct stent prevents PEP and to identify risk factors for PEP. METHODS: We analyzed data from 426 consecutive patients who underwent ERCP-related procedures at 37 endoscopic units. The patients were assigned randomly to groups that received stents (S group, n = 213) or did not (nS group, n = 213). The stent used was temporary, 5F in diameter, 3 cm long, and straight with an unflanged inner end. RESULTS: The overall frequency of PEP was 11.3%. The frequencies of PEP in the S and nS groups were 7.9% and 15.2%, respectively; the lower incidence of PEP in the S group was statistically significant based on the full analysis set (P = .021), although there was no statistically significant differences in an intention-to-treat analysis (P = .076). There were significant differences in PEP incidence between groups in multivariate analysis for the following risk factors: pancreatography first, nonplacement of a pancreatic duct stent after ERCP, procedure time of 30 minutes or more, sampling of pancreatic tissue by any method, intraductal ultrasonography, and difficulty of cannulation (≥15 min). Patients with more than 3 risk factors had a significantly greater incidence of pancreatitis. CONCLUSIONS: Placement of a pancreatic duct stent reduces the incidence of PEP. Several risk factors are associated with PEP. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/21749851/Endoscopic_pancreatic_duct_stents_reduce_the_incidence_of_post_endoscopic_retrograde_cholangiopancreatography_pancreatitis_in_high_risk_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(11)00693-8 DB - PRIME DP - Unbound Medicine ER -