Cost-Effectiveness and Efficacy of Biodegradable Pancreatic Stents for Preventing Post-ERCP Pancreatitis: A...

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) occurs in up to 10% of cases. Prophylactic pancreatic stenting reduces PEP risk; however, plastic stents frequently require an additional procedure for removal, increasing cost and patient burden. Biodegradable pancreatic stents negate the need for retrieval, but data on cost-effectiveness and clinical outcomes remain limited.

We conducted a two-center retrospective cohort study of adults undergoing ERCP with biodegradable pancreatic stent placement for PEP prophylaxis between January 2021 and August 2025. Demographic, procedural, and clinical data were collected. The primary outcome was per-patient cost difference between patient journeys utilizing biodegradable and plastic stenting. Secondary outcomes included PEP incidence, technical success, and stent usability data.

A total of 5086 ERPCs were performed during the study period, and 111 ERCPs with biodegradable stents inserted were analyzed (mean age 62 years; 57% female; 39% rural). Technical success was 98%. The mean cost difference per patient favored biodegradable stents by AUD$393 (95% CI 149-63, p = 0.002). PEP occurred in 11% (12/111), all of which were mild. Higher rates of PEP were noted in patients on anticoagulation (36% vs. 8%, p = 0.02), with a history of prior PEP (67% vs. 8%, p = 0.02), or with failed pancreatic stent placement (100% vs. 9%, p = 0.01). Endoscopists rated ease of use comparable to plastic stents.

Biodegradable pancreatic stent placement is technically safe, effective, and associated with significant cost savings and reduced patient/healthcare burden by negating the need for further procedures. Observed PEP rates were consistent with those reported in high-risk cohorts.