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The modified pancreatic stent system for prevention of post-ERCP pancreatitis: a case-control study.
BMC Gastroenterol 2017; 17(1):108BG

Abstract

BACKGROUND

Prophylactic pancreatic stents after endoscopic retrograde cholangiopancreatography (ERCP) can help prevent post-ERCP pancreatitis. However most of the pancreatic stents need to be removed by another ERCP. The aim of this observational study was to investigate the feasibility and effectiveness of the modified pancreatic stent system for prevention of post-ERCP pancreatitis.

METHODS

From November 2013 to November 2015, a total of 230 patients who had prophylactic pancreatic stent placed for prevention of post-ERCP pancreatitis at a single institution were identified and stratified. In this case-control design, 150 patients received an ordinary pancreatic stent, and 80 patients received the modified pancreatic stent. The main outcome measures were the difficulty level and complications of pancreatic stent placement and extraction between the two groups.

RESULTS

In ordinary group, the average time of pancreatic stent and nasal biliary drainage placement was 3.5 ± 0.6 min. There were 13 cases of stent proximal migration (8.7%), 20 cases of stent spontaneous abscission (13.3%), 5 cases of acute pancreatitis (3.3%) (2 cases for stent abscission) and 7 cases of hyperamylasemia (4.7%) after ERCP. One hundred thirty patients received extra duodenoscope (86.7%) to remove the stent, and 4 cases had acute pancreatitis and 5 patients had hyperamylasemia after removing the proximal migratory stents. In modified group, the average time of pancreatic stent system placement was 4.9 ± 0.7 min, but there was only one case of stent abscission (1.3%), 2 cases of acute pancreatitis (2.5%) and 3 cases of hyperamylasemia (3.8%). The new pancreatic stents were removed directly under x-ray without complication.

CONCLUSIONS

The modified pancreatic stent system has the same effect of preventing post-ERCP pancreatitis, lower rate of stents proximal migration and spontaneous abscission, and the advantage of easier removed compared with ordinary pancreatic stent.

Authors+Show Affiliations

Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China. yangyulong516@sina.com.Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29047328

Citation

Zhang, Cheng, et al. "The Modified Pancreatic Stent System for Prevention of post-ERCP Pancreatitis: a Case-control Study." BMC Gastroenterology, vol. 17, no. 1, 2017, p. 108.
Zhang C, Yang YL, Ma YF, et al. The modified pancreatic stent system for prevention of post-ERCP pancreatitis: a case-control study. BMC Gastroenterol. 2017;17(1):108.
Zhang, C., Yang, Y. L., Ma, Y. F., Zhang, H. W., Li, J. Y., Lin, M. J., ... Qi, C. C. (2017). The modified pancreatic stent system for prevention of post-ERCP pancreatitis: a case-control study. BMC Gastroenterology, 17(1), p. 108. doi:10.1186/s12876-017-0661-2.
Zhang C, et al. The Modified Pancreatic Stent System for Prevention of post-ERCP Pancreatitis: a Case-control Study. BMC Gastroenterol. 2017 Oct 18;17(1):108. PubMed PMID: 29047328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The modified pancreatic stent system for prevention of post-ERCP pancreatitis: a case-control study. AU - Zhang,Cheng, AU - Yang,Yu-Long, AU - Ma,Yue-Feng, AU - Zhang,Hong-Wei, AU - Li,Jing-Yi, AU - Lin,Mei-Ju, AU - Shi,Li-Jun, AU - Qi,Chun-Chun, Y1 - 2017/10/18/ PY - 2016/06/07/received PY - 2017/10/02/accepted PY - 2017/10/20/entrez PY - 2017/10/20/pubmed PY - 2018/5/31/medline KW - Acute pancreatitis KW - Endoscopic nasal biliary drainage KW - Endoscopic retrograde cholangio pancreatography KW - Pancreatic stent SP - 108 EP - 108 JF - BMC gastroenterology JO - BMC Gastroenterol VL - 17 IS - 1 N2 - BACKGROUND: Prophylactic pancreatic stents after endoscopic retrograde cholangiopancreatography (ERCP) can help prevent post-ERCP pancreatitis. However most of the pancreatic stents need to be removed by another ERCP. The aim of this observational study was to investigate the feasibility and effectiveness of the modified pancreatic stent system for prevention of post-ERCP pancreatitis. METHODS: From November 2013 to November 2015, a total of 230 patients who had prophylactic pancreatic stent placed for prevention of post-ERCP pancreatitis at a single institution were identified and stratified. In this case-control design, 150 patients received an ordinary pancreatic stent, and 80 patients received the modified pancreatic stent. The main outcome measures were the difficulty level and complications of pancreatic stent placement and extraction between the two groups. RESULTS: In ordinary group, the average time of pancreatic stent and nasal biliary drainage placement was 3.5 ± 0.6 min. There were 13 cases of stent proximal migration (8.7%), 20 cases of stent spontaneous abscission (13.3%), 5 cases of acute pancreatitis (3.3%) (2 cases for stent abscission) and 7 cases of hyperamylasemia (4.7%) after ERCP. One hundred thirty patients received extra duodenoscope (86.7%) to remove the stent, and 4 cases had acute pancreatitis and 5 patients had hyperamylasemia after removing the proximal migratory stents. In modified group, the average time of pancreatic stent system placement was 4.9 ± 0.7 min, but there was only one case of stent abscission (1.3%), 2 cases of acute pancreatitis (2.5%) and 3 cases of hyperamylasemia (3.8%). The new pancreatic stents were removed directly under x-ray without complication. CONCLUSIONS: The modified pancreatic stent system has the same effect of preventing post-ERCP pancreatitis, lower rate of stents proximal migration and spontaneous abscission, and the advantage of easier removed compared with ordinary pancreatic stent. SN - 1471-230X UR - https://www.unboundmedicine.com/medline/citation/29047328/The_modified_pancreatic_stent_system_for_prevention_of_post_ERCP_pancreatitis:_a_case_control_study_ L2 - https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-017-0661-2 DB - PRIME DP - Unbound Medicine ER -