title: Prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis by an endoscopic pancreatic spontaneous dislodgement stent.
abstract: OBJECTIVE
  Pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) is the most common and potentially serious complication of ERCP. The frequency of post-ERCP pancreatitis generally is reported to be between 1% and 9%. One cause of pancreatitis is retention of pancreatic juice resulting from papilledema after the procedure. We conducted a randomized controlled multicenter study to evaluate whether placement of a temporary pancreatic stent designed for spontaneous dislodgement prevents post-ERCP pancreatitis.
  
  
  METHODS
  The subjects were 201 consecutive patients who underwent ERCP. The patients were randomized into the stent placement group (S group = 98) or the nonstent placement group (nS group = 103). The stent used was 5F in diameter, 3 cm in length, straight, and unflanged inside.
  
  
  RESULTS
  Stents were placed successfully in 96% of the S group, and spontaneous stent dislodgment was recognized in 95.7% of those. The mean duration to dislodgment was 2 days, and there were no severe complications. The overall frequency of post-ERCP pancreatitis was 8.5%. The frequency of post-ERCP pancreatitis in the S and nS groups was 3.2% and 13.6%, respectively, showing a significantly lower frequency in the S group (P = .019). The mean increase in amylase level in the pancreatitis patients was significantly higher in the nS group (P = .014).
  
  
  CONCLUSIONS
  The randomized controlled multicenter trial showed that placement of a pancreatic spontaneous dislodgment stent significantly reduces post-ERCP pancreatitis.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan. a-sofuni@amy.hi-ho.ne.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Akio
authors.initials: A
authors.lastname: Katanuma
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hisai
authors.forename: Teitetsu
authors.initials: T
authors.lastname: Niido
authors.forename: Masayuki
authors.initials: M
authors.lastname: Toyota
authors.forename: Tsuneshi
authors.initials: T
authors.lastname: Fujii
authors.forename: Youji
authors.initials: Y
authors.lastname: Harada
authors.forename: Tadanori
authors.initials: T
authors.lastname: Takada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000032:analysis; D001660:Biliary Tract Diseases / Q000628:therapy; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000628:therapy; D010183:Pancreatic Ducts / Q000601:surgery; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control*; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000681:Amylases