title: Does a pancreatic duct stent prevent post-ERCP pancreatitis? A prospective randomized study.
abstract: 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.
authors.affiliation: Biliary Center, St. Lukes Hospital, Milwaukee, Wisconsin 53215, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Fazel
authors.forename: Affan
authors.initials: A
authors.lastname: Quadri
authors.forename: Marc F
authors.initials: MF
authors.lastname: Catalano
authors.forename: Scott M
authors.initials: SM
authors.lastname: Meyerson
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Geenen
mesh_terms: 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
chemical_list: D000681:Amylases