title: Impact of pancreatic stent caliber on post-endoscopic retrograde cholangiopancreatogram pancreatitis rates in patients with confirmed sphincter of Oddi dysfunction.
abstract: BACKGROUND
  Despite proven clinical benefit, there are no studies that have examined the relationship between pancreatic stent caliber and its impact on PEP [post-endoscopic retrograde cholangiopancreatogram (ERCP) pancreatitis] in high-risk patients.
  
  
  OBJECTIVE
  To study the relationship between stent caliber and PEP rates in patients with confirmed sphincter of Oddi dysfunction (SOD).
  
  
  METHODS
  A retrospective review was conducted of ERCP's in patients with SOD from 2002 to 2012 from a prospectively maintained, Institutional Review Board approved database.
  
  
  RESULTS
  A total of 243/7659 (3.2%) patients underwent 3Fr or 5Fr pancreatic stent placement following sphincterotomy for manometry-proven SOD. Of these, 133 (54.7%) underwent 3Fr stent placement, while 110 (45.3%) underwent 5Fr stent placement. There was no significant difference between the two groups in terms of baseline characteristics, demographics, and previous cholecystectomy. Cannulation and stent placement success rates were 100% in both groups. There was no significant difference in rates of PEP and overall complications, 12% versus 12.7%; P = 0.89 and 13.5% versus 15.5%; P = 0.54, between the 3Fr and 5Fr cohorts, respectively. There were more mild PEP rates recorded in 5Fr group (93% vs 56% P = 0.0549) that was not statistically significant.
  
  
  CONCLUSIONS
  There appears to be no relationship between stent characteristics and the risk or severity of PEP in patients with manometrically proven SOD.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Jayapal
authors.initials: J
authors.lastname: Ramesh
authors.forename: Hwasoon
authors.initials: H
authors.lastname: Kim
authors.forename: Kartika
authors.initials: K
authors.lastname: Reddy
authors.forename: Shyam
authors.initials: S
authors.lastname: Varadarajulu
authors.forename: C Mel
authors.initials: CM
authors.lastname: Wilcox
mesh_terms: D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012306:Risk; D012720:Severity of Illness Index; D009803:Sphincter of Oddi / Q000601:surgery; D046628:Sphincter of Oddi Dysfunction / Q000601:surgery*; D015607:Stents
keywords: ERCP; pancreatic stents; post-ERCP pancreatitis; sphincter of Oddi dysfunction