Biliary stent placement is associated with post-ERCP pancreatitis - 24/08/11
Reprint requests: C. Mel Wilcox, MD, MSPH, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL 35294-0007Riassunto |
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.
Il testo completo di questo articolo è disponibile in PDF.Abbreviation : OR
Mappa
| DISCLOSURE: A portion of this study was funded by K24 #D070629 (C.M.W.). All authors disclosed no financial relationships relevant to this publication. |
Vol 72 - N° 3
P. 546-550 - settembre 2010 Ritorno al numero
Articolo precedente
- Distal pancreatectomy: another indication for prophylactic pancreatic stenting?
- Jean-Marc Dumonceau
- Endotherapy of postoperative biliary strictures with multiple stents: results after more than 10 years of follow-up
- Guido Costamagna, Andrea Tringali, Massimiliano Mutignani, Vincenzo Perri, Cristiano Spada, Monica Pandolfi, Domenico Galasso
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?