Endoscopy 2025; 57(S 02): S18
DOI: 10.1055/s-0045-1805122
Abstracts | ESGE Days 2025
Oral presentation
ERCP – safety first! 03/04/2025, 09:00 – 10:00 Room 124+125

Risk factors of acute pancreatitis after endoscopic papillectomy for ampullary neoplasms: to stent or not to stent?

Authors

  • C Binda

    1   Forlì-Cesena Hospitals, AUSL Romagna, Forli, Italy

  • L Frazzoni

    1   Forlì-Cesena Hospitals, AUSL Romagna, Forli, Italy

  • S Fabbri

    1   Forlì-Cesena Hospitals, AUSL Romagna, Forli, Italy

  • M Mutignani

    2   ASST Great Metropolitan Niguarda, Milano, Italy

  • A Tringali

    3   Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

  • R Di Mitri

    4   A.R.N.A.S. Ospedali Civico Di Cristina Benfratelli, Palermo, Italy

  • A Fugazza

    5   Humanitas Research Hospital, Rozzano, Italy

  • S Romano

    6   AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy

  • A Gabbrielli

    7   Center for Medical Sciences (CISMed), University of Trento, Trento, Italy

  • P Arcidiacono

    8   Vita-Salute San Raffaele University, Milano, Italy

  • F M Di Matteo

    9   Bio-Medico Campus University Hospital, Rome, Italy

  • C Coluccio

    1   Forlì-Cesena Hospitals, AUSL Romagna, Forli, Italy

  • D M Marco

    10   Ospedale 'Infermi', AUSL Romagna, Rimini, Italy

  • C Spada

    3   Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

  • A Fantin

    11   Veneto Institute of Oncology IOV-IRCCS, Padova, Italy

  • C G De Angelis

    12   Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy

  • R Macchiarelli

    13   Azienda Ospedaliera Universitaria Senese​, Siena, Italy

  • F Perri

    14   Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy

  • M Manno

    15   Azienda Unità Sanitaria Locale di Modena, Carpi, Italy

  • L Cugia

    16   Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy

  • A Mussetto

    17   Santa Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy

  • L Dioscoridi

    2   ASST Great Metropolitan Niguarda, Milano, Italy

  • T Schepis

    3   Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

  • D Scimeca

    4   A.R.N.A.S. Ospedali Civico Di Cristina Benfratelli, Palermo, Italy

  • L Da Rio

    5   Humanitas Research Hospital, Rozzano, Italy

  • P Cecinato

    18   IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy

  • S F Crinò

    19   University of Verona, Verona, Italy

  • A Cucchetti

    20   Department of Medical and Surgical Sciences – DIMEC, Alma Mater Studiorum, Univeristy of Bologna, Bologna, Italy

  • A Facciorusso

    21   Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy

  • A Repici

    5   Humanitas Research Hospital, Rozzano, Italy

  • I Tarantino

    22   IRCCS-ISMETT, Palermo, Italy

  • A Anderloni

    23   Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy

  • C Fabbri

    1   Forlì-Cesena Hospitals, AUSL Romagna, Forli, Italy
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Aims Acute pancreatitis (AP) is the most frequent adverse event after endoscopic papillectomy (EP). Evidence supporting the ASGE/ESGE recommendation to place pancreatic duct (PD) stent mostly comes from small studies. We aimed to identify AP predictors and assess the efficacy of PD stenting prophylaxis.

Methods Retrospective analysis of data from the i-EUS study group collected at 19 Italian centers from 2016 to 2021. Patients who underwent EP for ampullary neoplasms were included. Logistic regression was performed to identify predictors of post-EP AP.

Results 414 patients (49.8% female; mean age 67.5±12.4 years) underwent EP for ampullary neoplasms (mean size 20+10.2mm). PD stent was placed in 350 (84.5%) cases. Final histology revealed low- grade dysplasia (LGD) in 51.2%, high-grade dysplasia (HGD) in 29.7%, and carcinoma in 19.1%. AP occurred in 36 (8.7%) cases. LGD was the only independent predictor of AP after EP (OR 2.58, 95% CI 1.08-6.14). PD stenting did not impact on the rate of AP, overall (p=0.834) and according to lesion histology (p=0.665 and p=0.888 for LGD and HGD or cancer, respectively) [1] [2] [3] [4] [5].

Conclusions We found a relatively low rate of AP after EP. PD stent placement did not significantly reduce the rate of AP. The presence of LGD was the only predictor for post-EP AP.



Publication History

Article published online:
27 March 2025

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