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Pancreatic stents for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis should be inserted up to the pancreatic body or tail.
World J Gastroenterol 2018; 24(22):2392-2399WJ

Abstract

AIM

To investigate the location to which a pancreatic stent should be inserted to prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).

METHODS

Over a ten-year period at our hospital, 296 patients underwent their first ERCP procedure and had a pancreatic stent inserted; this study included 147 patients who had ERCP performed primarily for biliary investigation and had a pancreatic stent inserted to prevent PEP. We divided these patients into two groups: 131 patients with a stent inserted into the pancreatic head (head group) and 16 patients with a stent inserted up to the pancreatic body or tail (body/tail group). Patient characteristics and ERCP factors were compared between the groups.

RESULTS

Pancreatic amylase isoenzyme (p-AMY) levels in the head group were significantly higher than those in the body/tail group [138.5 (7.0-2086) vs 78.5 (5.0-1266.5), P = 0.03] [median (range)]. No cases of PEP were detected in the body/tail group [head group, 12 (9.2%)]. Of the risk factors for post-ERCP hyperamylasemia (≥ p-AMY median, 131 IU/L), procedure time ≥ 60 min [odds ratio (OR) 2.65, 95%CI: 1.17-6.02, P = 0.02) and stent insertion into the pancreatic head (OR 3.80, 95%CI: 1.12-12.9, P = 0.03) were identified as independent risk factors by multivariate analysis.

CONCLUSION

Stent insertion up to the pancreatic body or tail reduces the risk of post-ERCP hyperamylasemia and may reduce the risk of PEP.

Authors+Show Affiliations

Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan. daccho@fmu.ac.jp.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 960-1247, Japan.Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29904246

Citation

Sugimoto, Mitsuru, et al. "Pancreatic Stents for the Prevention of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis Should Be Inserted Up to the Pancreatic Body or Tail." World Journal of Gastroenterology, vol. 24, no. 22, 2018, pp. 2392-2399.
Sugimoto M, Takagi T, Suzuki R, et al. Pancreatic stents for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis should be inserted up to the pancreatic body or tail. World J Gastroenterol. 2018;24(22):2392-2399.
Sugimoto, M., Takagi, T., Suzuki, R., Konno, N., Asama, H., Sato, Y., ... Ohira, H. (2018). Pancreatic stents for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis should be inserted up to the pancreatic body or tail. World Journal of Gastroenterology, 24(22), pp. 2392-2399. doi:10.3748/wjg.v24.i22.2392.
Sugimoto M, et al. Pancreatic Stents for the Prevention of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis Should Be Inserted Up to the Pancreatic Body or Tail. World J Gastroenterol. 2018 Jun 14;24(22):2392-2399. PubMed PMID: 29904246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreatic stents for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis should be inserted up to the pancreatic body or tail. AU - Sugimoto,Mitsuru, AU - Takagi,Tadayuki, AU - Suzuki,Rei, AU - Konno,Naoki, AU - Asama,Hiroyuki, AU - Sato,Yuki, AU - Irie,Hiroki, AU - Watanabe,Ko, AU - Nakamura,Jun, AU - Kikuchi,Hitomi, AU - Waragai,Yuichi, AU - Takasumi,Mika, AU - Hikichi,Takuto, AU - Ohira,Hiromasa, PY - 2018/02/27/received PY - 2018/03/29/revised PY - 2018/05/05/accepted PY - 2018/6/16/entrez PY - 2018/6/16/pubmed PY - 2018/10/26/medline KW - Endoscopic retrograde cholangiopancreatography KW - Pancreatic body or tail KW - Pancreatic stent KW - Post-endoscopic retrograde cholangiopancreatography hyperamylasemia KW - Post-endoscopic retrograde cholangiopancreatography pancreatitis SP - 2392 EP - 2399 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 24 IS - 22 N2 - AIM: To investigate the location to which a pancreatic stent should be inserted to prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). METHODS: Over a ten-year period at our hospital, 296 patients underwent their first ERCP procedure and had a pancreatic stent inserted; this study included 147 patients who had ERCP performed primarily for biliary investigation and had a pancreatic stent inserted to prevent PEP. We divided these patients into two groups: 131 patients with a stent inserted into the pancreatic head (head group) and 16 patients with a stent inserted up to the pancreatic body or tail (body/tail group). Patient characteristics and ERCP factors were compared between the groups. RESULTS: Pancreatic amylase isoenzyme (p-AMY) levels in the head group were significantly higher than those in the body/tail group [138.5 (7.0-2086) vs 78.5 (5.0-1266.5), P = 0.03] [median (range)]. No cases of PEP were detected in the body/tail group [head group, 12 (9.2%)]. Of the risk factors for post-ERCP hyperamylasemia (≥ p-AMY median, 131 IU/L), procedure time ≥ 60 min [odds ratio (OR) 2.65, 95%CI: 1.17-6.02, P = 0.02) and stent insertion into the pancreatic head (OR 3.80, 95%CI: 1.12-12.9, P = 0.03) were identified as independent risk factors by multivariate analysis. CONCLUSION: Stent insertion up to the pancreatic body or tail reduces the risk of post-ERCP hyperamylasemia and may reduce the risk of PEP. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/29904246/Pancreatic_stents_for_the_prevention_of_post_endoscopic_retrograde_cholangiopancreatography_pancreatitis_should_be_inserted_up_to_the_pancreatic_body_or_tail_ L2 - http://www.wjgnet.com/1007-9327/full/v24/i22/2392.htm DB - PRIME DP - Unbound Medicine ER -