title: Biliary stent placement is associated with post-ERCP pancreatitis.
abstract: BACKGROUND
  A variety of factors have been linked to post-ERCP pancreatitis. However, the role of biliary stenting has not been well studied.
  
  
  OBJECTIVE
  To evaluate the relationship between biliary stenting and post-ERCP pancreatitis.
  
  
  METHODS
  Prospective study of all patients undergoing ERCP with biliary stenting over a 7.5-year period. All patients had follow-up at 24 to 48 hours after the procedure and at 1 month.
  
  
  METHODS
  A single-center tertiary referral academic medical center.
  
  
  METHODS
  Consecutive patients undergoing ERCP over a 7.5-year period.
  
  
  METHODS
  Endoscopic therapy based on the indication for and findings of ERCP.
  
  
  METHODS
  The rate of post-ERCP pancreatitis.
  
  
  RESULTS
  A total of 3499 patients underwent ERCP with bile duct stent placement of a native papilla performed in 660: 544 (83%) 10F and 116 (17%) 7F. The most common indication for stent placement was pancreaticobiliary malignancy in 250 patients (37%). The overall rate of pancreatitis for the entire cohort was 3.17%. Multivariate analysis identified 6 factors that were associated with pancreatitis: previous ERCP pancreatitis (odds ratio [OR], 2.44; 95% CI, 1.31-4.55), age (OR, 2.30; 95% CI, 1.44-3.67), history of acute pancreatitis (OR, 1.78; 95% CI, 1.12-2.88), pancreatic sphincterotomy (OR, 2.30, 95% CI, 1.43-3.70), suspected sphincter of Oddi dysfunction (OR, 3.91; 95% CI, 2.36-6.46), and bile duct stenting (OR, 1.72; 95% CI, 1.03-2.88). The rates of pancreatitis were not significantly different based on performing sphincterotomy before stent placement, stent type, stent length, stent size, or indication.
  
  
  CONCLUSIONS
  Single-center study.
  
  
  CONCLUSIONS
  Bile duct stent placement is an independent predictor for pancreatitis, and pancreatitis is not related to performing sphincterotomy before stenting or to stent characteristics.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA.
authors.forename: C Mel
authors.initials: CM
authors.lastname: Wilcox
authors.forename: Milind
authors.initials: M
authors.lastname: Phadnis
authors.forename: Shyam
authors.initials: S
authors.lastname: Varadarajulu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018281:Cholangiocarcinoma / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D015331:Cohort Studies; D003138:Common Bile Duct Neoplasms / Q000628:therapy*; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000628:therapy*; D010195:Pancreatitis / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic; D015607:Stents / Q000009:adverse effects*; D055815:Young Adult