Endoscopy 2021; 53(S 01): S215
DOI: 10.1055/s-0041-1724856
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Prophylactic Pancreatic Stenting in ERC Biliary Cannulation. Effectivity and Stent Duration

P Stathopoulos
1   University Clinic Marburg, Clinic for Gastroenterology, Marburg, Germany
,
P Astheimer
1   University Clinic Marburg, Clinic for Gastroenterology, Marburg, Germany
,
P Lerner
1   University Clinic Marburg, Clinic for Gastroenterology, Marburg, Germany
,
L Breitling
1   University Clinic Marburg, Clinic for Gastroenterology, Marburg, Germany
,
U Denzer
1   University Clinic Marburg, Clinic for Gastroenterology, Marburg, Germany
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    Aims ERCP is the standard procedure for biliary access. In case of initial cannulation of the pancreatic duct a prophylactic pancreatic stent (PPS) declines the rate of post ERC pancreatitis (PEP). We have analyzed frequency, PEP rate and stent duration of PPS in the biliary cannulation of naive papilla in a tertiary care center.

    Methods All ERCP interventions from 1-2017 to 12-2019 were analysed. Parameters registered were indication, kind of intervention, house classification, anatomy, success of cannulation, PPS and PEP rate.

    Results 1610 ERCP interventions were undertaken (anatomy: 1564 normal, 46 postoperative (Roux-y or BII). Indications in normal anatomy: Biliary (+/- pancreatic) 95.6 % (1495); pancreatic 4.4 % (69). Distribution of house classification: Biliary (+/- pancreatic): House I n = 842, House II n =284, House III n= 363. Pancreatic: House II n = 55; House III N = 14.

    40.5 % (633/1564) of interventions with biliary indication (Malign obstruction 26.4 %, CDL 59.9 %, benign stenosis 4.4 %, biliary leakage 3.6 %, others 8,6 %) had a naive papilla.

    PPS after 1. or 2. guidewire cannulation of the pancreatic duct was inserted in 200/643 interventions (naive papilla/repeated ERC after precut). Removal of PPS after a means of 4.37 days (1-21). PEP rate: PPS +: 9 % (18/200) vs. PPS -: 4.5 % (20/443). PEP disease course: PPS +: Mild: 17; moderate 1; PPS -: Mild: 12; moderate: 4; severe: 4 (1 lethal with comorbidity).

    Total ERCP´s PEP rate: 3.1 % (48/1564) 36 mild, 8 moderate; 4 severe. After removal of the PPS no deterioration of PEP or new PEP occurred.

    Conclusions Insertion of a PPS in case of accidentally guidewire cannulation of the pancreatic duct significantly drops the rate of severe and moderate PEP courses. Removal of PPS did not lead to complications.

    Citation Stathopoulos P, Astheimer P, Lerner P et al. eP365 PROPHYLACTIC PANCREATIC STENTING IN ERC BILIARY CANNULATION. EFFECTIVITY AND STENT DURATION. Endoscopy 2021; 53: S215.


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    Publication History

    Article published online:
    19 March 2021

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