Journal article
Reducing the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis using 4-Fr pancreatic plastic stents placed with common-type guidewires: Results from a prospective multinational registry
Digestive endoscopy, Vol.31(3), pp.299-306
05/2019
DOI: 10.1111/den.13311
PMID: 30506606
Abstract
Pancreatic plastic stents (PPS) can reduce the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Prospective multicenter documentation of PEP rate after PPS placement is scarce. A new 4-Fr stent designed to be deployed over a 0.035-inch guidewire was used to assess the effectiveness of PEP prophylaxis.
High-PEP-risk patients received a 4-Fr PPS for primary or secondary prophylaxis at seven centers in four countries. Patients were followed until spontaneous PPS migration, endoscopic stent removal, or for 4 months, whichever came first. Main outcome was PEP rate.
One hundred six (106) patients received PPS for PEP prophylaxis [61 (58%) primary, 45 (42%) secondary prophylaxis]. Median age was 54 years. Eighty-one (76%) PPS were placed using a 0.035-inch guidewire. By investigator choice 99 (93%) stents were single pigtail. Median stent length was 8 cm (range 3-12 cm). Technical success achieved in 100% of cases. Two patients in the primary prophylaxis group (3%, 95% CI 0.4-11%) experienced mild/moderate PEP. Seventy-eight PPS available for analysis underwent spontaneous migration after a median of 29 days. There were no reports of stent-induced ductal trauma. Post-hoc analysis of migration rate by PPS length showed no statistically significant trend.
Among high-risk patients in the primary prophylaxis group, observed rates of PEP are low (3%, 95% CI 0.4-11%) with the use of prophylactic 4-Fr pancreatic duct stents compatible with a 0.035-inch guidewire. This low rate is not unequivocally due to the prophylactic stent.
Details
- Title: Subtitle
- Reducing the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis using 4-Fr pancreatic plastic stents placed with common-type guidewires: Results from a prospective multinational registry
- Creators
- Nadav Sahar - Virginia Mason Medical CenterAndrew Ross - Virginia Mason Medical CenterSundeep Lakhtakia - Asian Institute of GastroenterologyGregory A Coté - Medical University of South CarolinaHorst Neuhaus - Evangelical Hospital Dusseldorf, Dusseldorf, Germany.Marco J Bruno - Erasmus MCOleh Haluszka - Southern Arizona VA Health Care SystemRichard Kozarek - Virginia Mason Medical CenterMohan Ramchandani - Asian Institute of GastroenterologyTorsten Beyna - Evangelical Hospital Dusseldorf, Dusseldorf, Germany.Jan W Poley - Erasmus MCJennifer Maranki - Penn State Milton S. Hershey Medical CenterMartin Freeman - University of Minnesota SystemPrashant Kedia - Methodist Dallas Medical CenterPaul Tarnasky - Methodist Dallas Medical CenterPancreatic Stenting Registry Group
- Resource Type
- Journal article
- Publication Details
- Digestive endoscopy, Vol.31(3), pp.299-306
- DOI
- 10.1111/den.13311
- PMID
- 30506606
- ISSN
- 0915-5635
- eISSN
- 1443-1661
- Language
- English
- Date published
- 05/2019
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984359828402771
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