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Impact of pancreatic stent caliber on post-endoscopic retrograde cholangiopancreatogram pancreatitis rates in patients with confirmed sphincter of Oddi dysfunction.

AbstractBACKGROUND:
Despite proven clinical benefit, there are no studies that have examined the relationship between pancreatic stent caliber and its impact on PEP [post-endoscopic retrograde cholangiopancreatogram (ERCP) pancreatitis] in high-risk patients.
AIM:
To study the relationship between stent caliber and PEP rates in patients with confirmed sphincter of Oddi dysfunction (SOD).
METHODS:
A retrospective review was conducted of ERCP's in patients with SOD from 2002 to 2012 from a prospectively maintained, Institutional Review Board approved database.
RESULTS:
A total of 243/7659 (3.2%) patients underwent 3Fr or 5Fr pancreatic stent placement following sphincterotomy for manometry-proven SOD. Of these, 133 (54.7%) underwent 3Fr stent placement, while 110 (45.3%) underwent 5Fr stent placement. There was no significant difference between the two groups in terms of baseline characteristics, demographics, and previous cholecystectomy. Cannulation and stent placement success rates were 100% in both groups. There was no significant difference in rates of PEP and overall complications, 12% versus 12.7%; P = 0.89 and 13.5% versus 15.5%; P = 0.54, between the 3Fr and 5Fr cohorts, respectively. There were more mild PEP rates recorded in 5Fr group (93% vs 56% P = 0.0549) that was not statistically significant.
CONCLUSIONS:
There appears to be no relationship between stent characteristics and the risk or severity of PEP in patients with manometrically proven SOD.
AuthorsJayapal Ramesh, Hwasoon Kim, Kartika Reddy, Shyam Varadarajulu, C Mel Wilcox
JournalJournal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 29 Issue 7 Pg. 1563-7 ( 2014) ISSN: 1440-1746 [Electronic] Australia
PMID24617703 (Publication Type: Journal Article)
Copyright© 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
Topics
  • Adult
  • Cholangiopancreatography, Endoscopic Retrograde (adverse effects)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Ducts
  • Pancreatitis (epidemiology, etiology, prevention & control)
  • Retrospective Studies
  • Risk
  • Severity of Illness Index
  • Sphincter of Oddi (surgery)
  • Sphincter of Oddi Dysfunction (surgery)
  • Stents

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