Temporary pancreatic stent to prevent post endoscopic retrograde cholangiopancreatography pancreatitis: a preliminary, single-center, randomized controlled trial.
BACKGROUND
Post endoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis is the most common complication of ERCP, which can occasionally become serious or fatal. This preliminary study was to prospectively evaluate the efficacy of a temporary unflanged pancreatic duct stent (PS) to prevent post-ERCP pancreatitis.


METHODS
A total of 64 patients were randomly divided into a control group, which did not undergo stenting, and a stent group. The stent used was a 5-Fr pigtail PS without an inner flange.


RESULTS
Placement of an unflanged PS was successful and without complications in all 32 patients. The rates of hyperamylasemia were 50.0% and 34.4% in the control and stent groups, respectively (P > 0.05), and the mean serum amylase levels were 456.2 and 257.9 IU/l, respectively (P = 0.035). The overall rates of post-ERCP pancreatitis diagnosed according to Cotton's criteria were 12.5% and 3.1% in the control and stent groups, respectively (P > 0.05). The severity of pancreatitis was severe in one patient, moderate in one, and mild in two in the control group, whereas in the stent group, the single case of pancreatitis was mild.


CONCLUSIONS
Placement of an unflanged 5-Fr PS may be useful in preventing post-ERCP pancreatitis.
Tsuchiya
Takayoshi
T
Division of Gastroenterology, Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Tokyo 160-0023, Japan.
Itoi
Takao
T
Sofuni
Atsushi
A
Itokawa
Fumihide
F
Kurihara
Toshio
T
Ishii
Kentaro
K
Tsuji
Syujiro
S
Kawai
Takashi
T
Moriyasu
Fuminori
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000601:surgery; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery*; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012086:Reoperation; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects / Q000379:methods; D015607:Stents; D016896:Treatment Outcome