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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(10): E1162-E1170
DOI: 10.1055/a-2409-1285
Original article

Real-world evidence comparing early and late pancreatic stent placement to prevent post-ERCP pancreatitis

Shaofei Wang‡
1   Department of Gastroenterology, Suzhou First People's Hospital, Suzhou, Anhui Province, China
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Bingqing Bai‡
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Qiming Huang
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Yuanyuan Fang
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Chenyu Zhang
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Xinwen Chen
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Jianglong Hong
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Lei Jie
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Hao Ding
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Cui Hu
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Hongye Li
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Yang Li
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Xiaochang Liu
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Rutao Hong
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Junjun Bao
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
qiao Mei 
2   Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
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Abstract

Background and study aims Pancreatic stenting effectively lowers the occurrence of post-ERCP pancreatitis (PEP) and reduces its severity. However, limited research has been conducted to determine the optimal timing for pancreatic stent placement. Our objective was to evaluate whether early pancreatic stent placement (EPSP) is more effective than late pancreatic stent placement (LPSP) in preventing PEP among patients with naive papilla.

Patients and methods We conducted a retrospective cohort study that analyzed 590 patients with difficult biliary cannulation using the pancreatic guidewire technique, who were divided into EPSP and LPSP groups. In the EPSP group, a pancreatic stent was placed immediately before/after endoscopic retrograde cholangiography (ERC) or endoscopic sphincterotomy (EST). Conversely, in the LPSP group, a pancreatic stent was placed after partial/all completion of major endoscopic procedures.

Results From November 2017 to May 2023, 385 patients were in the EPSP group and 205 in the LPSP group. EPSP was associated with a decreased PEP occurrence compared with LPSP (2.9% vs. 7.3%; P = 0.012). Similarly, hyperamylasemia was lower in the EPSP group (19.7% vs. 27.8%; P = 0.026). Furthermore, sensitivity analysis using multivariable analysis and propensity score–matched (PSM) analysis also validated these findings.

Conclusions Early pancreatic stent placement reduced the incidence of PEP and hyperamylasemia compared with late pancreatic stent placement. Our findings favor pancreatic stenting immediately before/after ERC or EST.

Keywords

Pancreatobiliary (ERCP/PTCD) - ERC topics - Statistics

Supplementary Material



Publication History

Received: 08 May 2024

Accepted after revision: 03 September 2024

Accepted Manuscript online:
09 September 2024

Article published online:
15 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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