Journal article
Effect of prophylactic main pancreatic duct stenting on the incidence of biliary endoscopic sphincterotomy-induced pancreatitis in high-risk patients
Gastrointestinal endoscopy, Vol.39(5), pp.652-657
1993
DOI: 10.1016/S0016-5107(93)70217-5
PMID: 8224687
Abstract
Pancreatitis is a common complication of endoscopic sphincterotomy. Cautery-induced papillary edema has been implicated as a possible cause. The objective of this study was to determine whether prophylactic stenting of the main pancreatic duct after endoscopic sphincterotomy in high-risk patients would reduce the incidence of pancreatitis. High-risk patients were defined as those with sphincter of Oddi dysfunction, small common bile duct diameter (<10 mm), or those requiring pre-cut sphincterotomy. Patients were studied in a prospective fashion from October 1990 to April 1992 and were randomized to receive either a main pancreatic duct stem or no stent after biliary sphincterotomy. The stents were generally removed 10 to 14 days after placement. Fifty patients were randomized to the no-stent group and 48 patients were randomized to the stent group, but in five patients stent placement was unsuccessful. Pancreatitis occurred in 18% of patients in the no-stent group compared with 14% of patients in the stent group. Most cases of pancreatitis were mild, occurring in 10% of patients in the no-stent group and 12% of patients in the stent group. Moderate to severe pancreatitis occurred with an increased frequency in patients in the no-stent group (8%) compared with that in patients in the stent group (2%). Mean number of hospital days required to treat pancreatitis was 9.5 days in the no-stent group compared with 2.8 days in the stent group; however, none of these differences reached statistical significance. Small common bile duct diameter (<6 mm) was found to be an independent risk factor for pancreatitis after endoscopic sphincterotomy. In summary, prophylactic stenting of the main pancreatic duct did not decrease the incidence of pancreatitis in high-risk patients. Such stenting is not recommended for clinical practice.
Details
- Title: Subtitle
- Effect of prophylactic main pancreatic duct stenting on the incidence of biliary endoscopic sphincterotomy-induced pancreatitis in high-risk patients
- Creators
- Amy SmithlineWilliam SilvermanDavid RogersRodney NisiMaurits WiersemaPriya JamidarRobert HawesGlen Lehman
- Resource Type
- Journal article
- Publication Details
- Gastrointestinal endoscopy, Vol.39(5), pp.652-657
- Publisher
- Mosby, Inc
- DOI
- 10.1016/S0016-5107(93)70217-5
- PMID
- 8224687
- ISSN
- 0016-5107
- eISSN
- 1097-6779
- Language
- English
- Date published
- 1993
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984094717302771
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