Nonprevention of post-endoscopic retrograde cholangiopancreatographic pancreatitis by pancreatic stent after aspiration of pure pancreatic juice in patients with intraductal papillary mucinous neoplasms of the pancreas.
OBJECTIVE
The objective of this study was to evaluate the efficacy of a pancreatic stent regarding the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis after aspiration of pure pancreatic juice in patients with intraductal papillary mucinous neoplasms.


METHODS
A retrospective study was made to assess the outcome in 121 consecutive patients with intraductal papillary mucinous neoplasms who underwent endoscopic aspiration of pure pancreatic juice for cytologic examination between July 2001 and October 2007. From July 2001 to March 2004, 58 patients did not undergo pancreatic stent insertion (the no-stent [nS] group). The remaining 63 patients did undergo stent insertion (stent [S] group).


RESULTS
The overall incidences of post-ERCP pancreatitis was 11 (9.1%). The incidences of post-ERCP pancreatitis in the S and nS groups were 8 (12.7%) and 3 (5.2%; P = 0.21), respectively. In the male patients and the patients with a smaller diameter of the main pancreatic ducts, post-ERCP pancreatitis was seen more frequently in those in the S group (13% and 21%, respectively) than in those in the nS group (0% and 0%, respectively; P = 0.04, 0.03).


CONCLUSIONS
The pancreatic stent did not seem to decrease the incidence of post-ERCP pancreatitis in patients with intraductal papillary mucinous neoplasms. Furthermore, the pancreatic stent seems to be potentially detrimental in male patients and in patients with small-diameter main pancreatic ducts.
Harada
Ryo
R
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Kurashiki Central Hospital, Okayama 700-8558, Japan.
Kawamoto
Hirofumi
H
Fukatsu
Hirotoshi
H
Kato
Hironari
H
Hirao
Ken
K
Kurihara
Naoko
N
Mizuno
Osamu
O
Ogawa
Tsuneyoshi
T
Ishida
Etsuji
E
Okada
Hiroyuki
H
Yamamoto
Kazuhide
K
Yamamoto
Hiroshi
H
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000473:pathology; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010189:Pancreatic Juice / Q000166:cytology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D015607:Stents