title: [The safety assessment of percutaneous transhepatic transpapillary stent insertion in malignant obstructive jaundice: regarding the risk of pancreatitis and the effect of preliminary endoscopic sphincterotomy].
abstract: OBJECTIVE
  Metal stent insertion through percutaneous transhepatic biliary drainage (PTBD) track is an important palliative treatment modality for malignant biliary obstruction. Acute pancreatitis is one of serious complications of biliary metal stenting. The purpose of this study was to investigate the risk of pancreatitis for patients who underwent metal stent insertion via PTBD track.
  
  
  METHODS
  A retrospective analysis of 90 consecutive patients who received metal stent insertion via PTBD track from Jan. 2002 to Dec. 2007 was carried out. Patients were divided into the transpapillary and non-transpapillary group, and the risks of pancreatitis were compared. The effects of preliminary endoscopic sphincterectomy (EST) was also investigated in transpapillary group.
  
  
  RESULTS
  The rate of pancreatitis was higher in transpapillary group compared to nontranspapillary group (odd ratio 1.87, 95% CI 0.516-6.761), but it showed no stastically significance (p=0.502). In transpapillary group, patients who received preliminary EST showed lower rate of pancreatitis (odd ratio 0.91, 95% CI 0.656-1.273), but it showed no stastically significance (p=0.614).
  
  
  CONCLUSIONS
  Metallic stent insertion through the intact sphincter of Oddi might have a risk of developing pancreatitis. Further study is needed to elucidate the mechanism of pancreatitis and the way of prevention.
authors.affiliation: Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Young Wook
authors.initials: YW
authors.lastname: Jeong
authors.forename: Kyong Deok
authors.initials: KD
authors.lastname: Shin
authors.forename: Seong Hun
authors.initials: SH
authors.lastname: Kim
authors.forename: In Hee
authors.initials: IH
authors.lastname: Kim
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Kim
authors.forename: Kyong Ae
authors.initials: KA
authors.lastname: Lee
authors.forename: Byung Jun
authors.initials: BJ
authors.lastname: Jeon
authors.forename: Seung Ok
authors.initials: SO
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000378:metabolism; D002779:Cholestasis / Q000175:diagnosis / Q000601:surgery*; D004322:Drainage; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D016717:Sphincterotomy, Endoscopic; D015607:Stents / Q000009:adverse effects*
chemical_list: D000681:Amylases