Gut Liver.  2014 May;8(3):306-312.

Prophylactic Pancreatic Stent Placement for Endoscopic Duodenal Ampullectomy: A Single-Center Retrospective Study

• Chang WI
• Min YW
• Yun HS
• Lee KH
• Lee JK
• Lee KT
• Rhee PL

Abstract

BACKGROUND/AIMS
We investigated the efficacy of prophylactic pancreatic stent placement for preventing postprocedure pancreatitis in patients undergoing endoscopic papillectomy.
METHODS
This retrospective study included 82 consecutive patients who underwent endoscopic papillectomy for benign ampullary neoplasm at Samsung Medical Center between August 2002 and June 2011. The patients were subdivided into two groups, namely, those who received prophylactic pancreatic stent placement and those who did not. Patient demographics, baseline blood test, tumor characteristics, and endoscopic treatment data were collected. The primary endpoint was postprocedure pancreatitis.
RESULTS
There was no difference in the development of postprocedure pancreatitis between the stent group and the no stent group (6/54, 10.5% and 2/28, 7.14%, respectively; p=1.00). At baseline, there were no significant differences between the two groups in terms of their risk factors for pancreatitis except pancreatic duct dye injection. The stent group was more likely to have dye injection than the nonstent group (100% vs 42.8%, p<0.001). However, in a logistic regression analysis, no significant difference was observed in the risk factors for pancreatitis including dye injection.
CONCLUSIONS
Our data suggest that routine prophylactic pancreatic duct stent placement in all patients undergoing endoscopic papillectomy may not be necessary and that large-scale prospective studies are required to identify the subgroup of patients who would benefit.

Keyword

Endoscopic papillectomy; Pancreatic stent; Postprocedure pancreatitis

MeSH Terms

Adult
Aged
Aged, 80 and over
Ampulla of Vater/surgery
Cholangiopancreatography, Endoscopic Retrograde
Common Bile Duct Neoplasms/*surgery
Endoscopy/methods
Female
Humans
Male
Middle Aged
Pancreatic Ducts/surgery
Pancreatitis/*prevention & control
Postoperative Complications/*prevention & control
Retrospective Studies
Sphincterotomy, Endoscopic/methods
*Stents