Medline ® Abstract for Reference 41
of 'Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis'
Biliary stent placement is associated with post-ERCP pancreatitis.
Wilcox CM, Phadnis M, Varadarajulu S
Gastrointest Endosc. 2010;72(3):546.
BACKGROUND: A variety of factors have been linked to post-ERCP pancreatitis. However, the role of biliary stenting has not been well studied.
OBJECTIVE: To evaluate the relationship between biliary stenting and post-ERCP pancreatitis.
DESIGN: Prospective study of all patients undergoing ERCP with biliary stenting over a 7.5-year period. All patients had follow-up at 24 to 48 hours after the procedure and at 1 month.
SETTING: A single-center tertiary referral academic medical center.
PATIENTS: Consecutive patients undergoing ERCP over a 7.5-year period.
INTERVENTIONS: Endoscopic therapy based on the indication for and findings of ERCP.
MAIN OUTCOME MEASUREMENTS: The rate of post-ERCP pancreatitis.
RESULTS: A total of 3499 patients underwent ERCP with bile duct stent placement of a native papilla performed in 660: 544 (83%) 10F and 116 (17%) 7F. The most common indication for stent placement was pancreaticobiliary malignancy in 250 patients (37%). The overall rate of pancreatitis for the entire cohort was 3.17%. Multivariate analysis identified 6 factors that were associated with pancreatitis: previous ERCP pancreatitis (odds ratio [OR], 2.44; 95% CI, 1.31-4.55), age (OR, 2.30; 95% CI, 1.44-3.67), history of acute pancreatitis (OR, 1.78; 95% CI, 1.12-2.88), pancreatic sphincterotomy (OR, 2.30, 95% CI, 1.43-3.70), suspected sphincter of Oddi dysfunction (OR, 3.91; 95% CI, 2.36-6.46), and bile duct stenting (OR, 1.72; 95% CI, 1.03-2.88). The rates of pancreatitis were not significantly different based on performing sphincterotomy before stent placement, stent type, stent length, stent size, or indication.
LIMITATIONS: Single-center study.
CONCLUSIONS: Bile duct stent placement is an independent predictor for pancreatitis, and pancreatitis is not related to performing sphincterotomy before stenting or to stent characteristics.
Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA.