Authors: Patrick T F Kennedy Evangelos Russo Naveenta Kumar Nick Powell Devinder Bansi Andrew Thillainayagam Panagiotis Vlavianos David Westaby
Publish Date: 2010/01/29
Volume: 24, Issue: 8, Pages: 1923-1928
Abstract
The use of temporary prophylactic pancreatic duct PD stents in the prevention of postendoscopic retrograde cholangiopancreatography ERCP pancreatitis in highrisk patients has been shown to be effective in multiple trials However there are limited data on the clinical implications of PD stents and their impact on practice outside of the trial settingThe utility of prophylactic pancreatic stenting was evaluated in a retrospective analysis of 1000 consecutive ERCPs performed in a single tertiary referral pancreatobiliary center over a 24month period based upon a predetermined protocol to identify patients at high risk of postprocedure pancreatitisOne thousand procedures performed in 688 patients were studied Sixtyone patients were considered for stent placement and stents were successfully placed in 58 cases The overall rate of postERCP pancreatitis in our study population was 36 The rate of pancreatitis in the stented patients was considered high at 224 but the majority 69 were classified as mild and there were no reported severe episodes This compares to pancreatitis in the nonstented group in whom the majority 739 experienced either moderate or severe episodesA strategy of prophylactic PD stents in this study has eliminated severe postERCP pancreatitis in highrisk patients However the high pancreatitis rate in stented patients may represent the cost to achieve this while stent type and size employed are likely contributing factors To maximize the benefits of PD stenting there is a need to identify and treat all those considered at high risk
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