Endoscopy 2025; 57(S 02): S392
DOI: 10.1055/s-0045-1805991
Abstracts | ESGE Days 2025
ePosters

Effectiveness of pancreatic stent placement in preventing post-ERCP pancreatitis: Experience of a Referral Center

Authors

  • M Velegraki

    1   Venizeleion General Hospital, Department of Gastroenterology, Heraklion, Greece
  • I Psaroudakis

    1   Venizeleion General Hospital, Department of Gastroenterology, Heraklion, Greece
  • D Arna

    1   Venizeleion General Hospital, Department of Gastroenterology, Heraklion, Greece
  • A Psistakis

    1   Venizeleion General Hospital, Department of Gastroenterology, Heraklion, Greece
  • M Fragaki

    1   Venizeleion General Hospital, Department of Gastroenterology, Heraklion, Greece
  • A Theodoropoulou

    1   Venizeleion General Hospital, Department of Gastroenterology, Heraklion, Greece
  • E Vardas

    1   Venizeleion General Hospital, Department of Gastroenterology, Heraklion, Greece
  • G Paspatis

    1   Venizeleion General Hospital, Department of Gastroenterology, Heraklion, Greece
 

Aims Cannulation of the common bile duct (CBD) during ERCP can be challenging in many cases. This study aims to evaluate the effectiveness of using a pancreatic stent (PS) in these cases to prevent post-ERCP pancreatitis (PEP). It is the first organized study of this kind in Greece and Europe.

Methods A retrospective record of patients undergoing their first ERCP between 1/1/2008 and 1/3/2024 at Venizeleion General Hospital (Crete, Greece), where a PS was placed due to unintended pancreatic duct cannulation on three or more attempts. Since 2015, all patients received a diclofenac suppository.

Results Of the 6080 patients who underwent ERCP, 421 were included in this study (46.1% male). The mean age was 67.8 years (± 15.8). The primary indications for ERCP were choledocholithiasis (57.7%), biliary or pancreatic malignancies (26.6%), and benign CBD strictures (5.7%). Successful CBD cannulation was achieved in the first session for 364 patients (86.4%), with 11 (2.6%) undergoing transpancreatic sphincterotomy and 6 (1.4%) a needle-knife procedure. A second ERCP attempt was made in 33 patients (7.8%), achieving 100% success in CBD cannulation. Balloon dilation of the ampulla of Vater was performed in 39 cases (9.3%). PEP occurred in 21 patients (4.9%), of whom only 3 (0.7%) had severe cases. Incidence was higher in women compared to men (18/227 vs 3/194, p=0.001), while diclofenac administration did not significantly affect PEP incidence (12/202 vs 9/219, p=0.4). Overall, there were 3 deaths, one of which was related to PEP (0.2%).

Conclusions The use of PS was associated with a low incidence of severe PEP, while diclofenac administration did not significantly affect PEP incidence. Additionally, PS placement in patients undergoing a second ERCP facilitated successful CBD cannulation in all cases.



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Artikel online veröffentlicht:
27. März 2025

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