Prophylactic Pancreatic Stents in High-Risk Population and Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

  • Hossein Ajdarkosh Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Firoozgar Hospital, Tehran
  • Gholamreza Hemasi Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Firoozgar Hospital, Tehran
  • Farhad Zamani Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Firoozgar Hospital, Tehran
  • Masoudreza Sohrabi Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Firoozgar Hospital, Tehran
  • Mohammad Mahdi Zamani Department of Anesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran
  • Mahmoodreza Khoonsari Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Firoozgar Hospital, Tehran
Keywords: Pancreatitis, Complications, Endoscopy, Pancreatic stent

Abstract

Background: Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography (ERCP). Several medical and surgical procedures have been analyzed in prevention of post-ERCP pancreatitis as a major post-ERCP complication, so we conducted a study to assess the role of prophylactic pancreatic stents on prevention and severity of post-ERCP pancreatitis. Materials and Methods: This case control studied adult patients undergoing ERCP at the ERCP unit of a referral educational hospital. Data of the case (stent, N=90) and control (non-stent) (N=105) groups were retrieved from medical records. In our center, sphinctrerotomy was performed for 103 patients of non-stent group and successful pancreatic stent placement was done in 86 patients of stent group in a standard fashion. In stent group, a 5F, 4 centimeter pancreatic stent was emplaced over a guide wire under fluoroscopic guidance. All post–ERCP pancreatitis and major complications of all patients were retrieved too. Results: Of 255 enrolled patients, 195 were at high risk of post-ERCP pancreatitis allocated in two groups of this study. Successful pancreatic stent placement was done in 86 patients (95.6%) of stent group. There was no major complication during procedures. The migration of pancreatic duct stent was diagnostic in 3 (3.5%) patients. The overall post ERCP pancreatitis was 4.0% and 16.6% in stent and non-stent groups, respectively. Conclusion: Based on our findings in this study, we strongly recommended pancreatic duct stent placement in high-risk patients; although the experience of endoscopist plays a crucial role. [GMJ.2015;4(2):67-71]

Author Biography

Mohammad Mahdi Zamani, Department of Anesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran
Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran

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Published
2015-03-16
How to Cite
Ajdarkosh, H., Hemasi, G., Zamani, F., Sohrabi, M., Zamani, M. M., & Khoonsari, M. (2015). Prophylactic Pancreatic Stents in High-Risk Population and Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis. Galen Medical Journal, 4(2), 67-71. https://doi.org/10.31661/gmj.v4i2.234
Section
Original Article