EFFICACY OF PANCREATIC STENTS IN A REAL-WORLD PRACTICE: 10-YEAR RETROSPECTIVE COMPREHENSIVE STUDY

Aims Recent data have shown an increase in the incidence of [post- endoscopic retrograde cholangio-pancreatography (ERCP) pancreatitis] (PEP) among hospitalized patients having ERCP. Pancreatic duct stent (PDS) placement seems to facilitate common bile duct (CBD) access and reduces the rate of PEP. However, endoscopists, feel uncomfortable placing a PDS. Most information regarding PDS comes from randomized control trials. In this study, we present a retrospective analysis of prospectively collected data, focusing on the effectiveness of PDS placement in assisting CBD cannulations and in preventing PEP, in real world practise.

Methods Eligible patients were those who underwent ERCP procedures with a PDS placement and they had a naive papilla. The PDS was placed after three inadvertent guidewire passages into the pancreatic duct.

Results A total of 4830 patients underwent ERCP between 2010-2020, with PEP rate 5.1% and cannulation rate 93%. Among them, 289 met the inclusion criteria (133 males, mean age:67yrs). Indications are presented in Table 1. In 253 patients CBD cannulation was achieved after the placement of the PDS in the same procedure, whereas in 21 patients in a second ERCP. In 15 patients the cannulation was not possible. One patient developed severe PEP and another one PDS migration into the duct.

Conclusions Our data have shown that the PDS placement facilitates the CBD cannulation in difficult cases without significant side effects. Also, it seems to reduce the incidence of the PEP and therefore PDS use should not be avoided when the indication is fulfilled.

[Table 1.]

Table 1

Indication
CBD stones	168
Malignant CBD stricture	90
Benign CBD stricture	18
Bile leak	13

Publication History

Article published online:
14 April 2022