Does a pancreatic duct stent prevent post-ERCP pancreatitis? A prospective randomized study.
BACKGROUND
Pancreatitis is the most frequent complication of ERCP. Injury to the papilla during ERCP could obstruct pancreatic duct outflow and initiate pancreatitis. A randomized prospective study was performed to evaluate the effect of pancreatic duct stent placement on the frequency and severity of post-ERCP pancreatitis in a selected group of patients.


METHODS
The study group consisted of patients over 18 years of age at high risk for post-ERCP pancreatitis because of a difficult cannulation, sphincter of Oddi manometry, and/or the performance of endoscopic sphincterotomy. Patients were prospectively randomized to have a pancreatic duct stent placed or no stent upon completion of the ERCP. The endoprosthesis used was either a 5F nasopancreatic catheter or 5F, 2-cm long pancreatic stent. Study endpoints were the frequency and severity of post-ERCP pancreatitis.


RESULTS
Patients undergoing pancreatic duct stent placement had a lower frequency of post-ERCP pancreatitis as compared with those in the control group (28% vs. 5%; p < 0.05). Pancreatitis tended to be less severe in patients who had pancreatic duct drainage.


CONCLUSIONS
Pancreatic duct stent insertion after ERCP reduces the frequency of post-ERCP pancreatitis in patients at high risk for this complication.
Fazel
Ali
A
Biliary Center, St. Lukes Hospital, Milwaukee, Wisconsin 53215, USA.
Quadri
Affan
A
Catalano
Marc F
MF
Meyerson
Scott M
SM
Geenen
Joseph E
JE
D000328:Adult; D000681:Amylases / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D015607:Stents
D000681:Amylases