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Pancreatic stenting to prevent post-ERCP pancreatitis: a randomized multicenter trial
Veit Phillip1, Aldis Pukitis2, Alexey Epstein3
1Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar, Technische Universität München, München, Germany.
Endoscopy International Open
|July 9, 2019
Summary
Pancreatic stenting effectively prevents post-ERCP pancreatitis (PEP) in patients with inadvertent pancreatic duct cannulation during first-time ERCP. This safe procedure significantly reduces PEP risk in an unselected population.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
Background:
- Acute pancreatitis (AP) is a common cause of hospitalization.
- Post-ERCP pancreatitis (PEP) is a frequent complication of ERCP.
- Pancreatic stenting is a potential prophylactic measure against PEP.
Purpose of the Study:
- To investigate the risk of PEP following inadvertent pancreatic duct cannulation during first-time ERCP.
- To evaluate the efficacy of prophylactic pancreatic stenting in reducing PEP.
- To determine if pancreatic stenting benefits an unselected patient population.
Main Methods:
- A multicenter, prospective, randomized controlled trial involving 167 patients undergoing first-time ERCP.
- Patients with inadvertent pancreatic duct cannulation were randomized to receive either a pancreatic stent or no routine intervention.
- Data were analyzed to compare PEP rates between the two groups.
Main Results:
- Prophylactic pancreatic stent insertion significantly reduced the rate of PEP (OR 0.43; P=0.04).
- The number needed to treat to prevent one case of PEP was 8.1.
- Pancreatic stenting was found to be a safe and feasible intervention.
Conclusions:
- Inadvertent pancreatic duct cannulation during first-time ERCP poses a significant risk of PEP.
- Prophylactic pancreatic stenting is an effective strategy to mitigate this risk.
- Pancreatic stenting is a safe and feasible prophylactic measure for patients undergoing ERCP.
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