Pancreatitis is the most frequent complication of ERCP. Injury to the papilla during ERCP may obstruct pancreatic duct outflow and initiate pancreatitis.
In this study, researchers evaluated the effect of pancreatic duct stent placement on the frequency and severity of post-ERCP pancreatitis in a selected group of patients.
|Frequency of post-ERCP pancreatitis:|
- stent group = 5%
- control group = 28%
Their findings are published in the March issue of Gastrointestinal Endoscopy.
The team included patients over 18 years of age at high risk for post-ERCP pancreatitis. High risks were due to a difficult cannulation, sphincter of Oddi manometry, and/or the performance of endoscopic sphincterotomy.
The team prospectively randomized patients to receive either a pancreatic duct stent or no stent (control group), upon completion of the ERCP.
The endoprosthesis used was either a 5F nasopancreatic catheter or 5F, 2-cm long pancreatic stent.
The researchers measured the study endpoints as the frequency and severity of post-ERCP pancreatitis.
The research team found that patients undergoing pancreatic duct stent placement had a lower frequency of post-ERCP pancreatitis, compared to the control group (5% versus 28%, respectively).
Furthermore, pancreatitis tended to be less severe in patients who had pancreatic duct drainage.
Dr Ali Fazel's team concluded, "Pancreatic duct stent insertion after ERCP reduces the frequency of post-ERCP pancreatitis in patients at high risk for this complication".