Is There Any Difference in Outcomes Between Long Pigtail and Short Flanged Prophylactic Pancreatic Duct Stents?

Abstract

Long (>3 cm) pigtail PD stent due to their specific design showed better outcomes as compared to short (<3 cm) flanged PD stent in preventing PEP and spontaneous stent dislodgement rates. However, further prospective trials are needed.

The impact of prophylactic pancreatic stenting on post‐ERCP pancreatitis: A nationwide, register‐based study

“…12–28 However, the issue of diameter of the pancreatic stent is addressed in only a few studies, mostly single-center reports, and with conflicting results. 29–33…”

“…Several previous studies have shown beneficial effects from prophylactic PS in reducing PEP 12–28 . However, the issue of diameter of the pancreatic stent is addressed in only a few studies, mostly single‐center reports, and with conflicting results 29–33 …”

Reducing the risk of post‐endoscopic retrograde cholangiopancreatography pancreatitis using 4‐Fr pancreatic plastic stents placed with common‐type guidewires: Results from a prospective multinational registry

“…It should be emphasized that assessment of PPS migration was not prescribed per protocol in the immediate post‐PPS placement days; hence, observation of PPS migration was based on a wide range of assessment time points per local practice of patient follow up. Interestingly, other studies reported superiority of shorter 3‐cm 5‐Fr pancreatic stents compared to longer 5‐cm 5‐Fr stents in preventing PEP, yet the opposite conclusion was reached when comparing >3 cm 4‐Fr pigtail stents to <3 cm 4‐Fr straight stents . Clearly, the recommended prophylactic PPS length needs to be further defined.…”

“…Interestingly, other studies reported superiority of shorter 3-cm 5-Fr pancreatic stents compared to longer 5-cm 5-Fr stents in preventing PEP, 26,27 yet the opposite conclusion was reached when comparing >3 cm 4-Fr pigtail stents to <3 cm 4-Fr straight stents. 28 Clearly, the recommended prophylactic PPS length needs to be further defined.…”

Prevention of post-ERCP pancreatitis

“…Ductal changes occurred in 24% of the patients with 3-4F stents implanted compared to 80% in those with 5-6F stents. In another study (54), duodenal pig-tail stents were compared with flapped stents. PEP incidence was found as 3% in the pig-tail group and 13.6% in the flapped group (p=0.019), and the spontaneous dislodgement rate was 95.4% in the pig-tail group and 81.8% in flapped group (p=0.007).…”