Placement of prophylactic pancreatic stents to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients: A meta-analysis

Abstract

Placement of prophylactic pancreatic stents may lower the incidence of post-ERCP pancreatitis in high-risk patients and alleviate the severity of this condition.

Risk factors of post‐ endoscopic retrograde cholangiopancreatography pancreatitis in biliary type sphincter of Oddi dysfunction in Japanese patients

“…The reason for this result may be due to the fact that pancreatic stents may have been inserted in patients with higher risk of PEP because this study is not a randomized controlled study. Regardless of this reason, we should keep in mind that pancreatic stents cannot completely prevent PEP in SOD, but they may reduce the disease severity . In the present study, the severity of pancreatitis in six patients with pancreatic stent placement was mild to moderate and severe pancreatitis occurred in a patient without pancreatic stent.…”

Left Hepatic Artery Pseudoaneurysm Caused by Acute Pancreatitis

“…Pancreatic duct stents and/or postprocedure rectal nonsteroidal anti-inflammatory drug suppositories should be utilized to lower the risk of severe post-ERCP pancreatitis (PEP) in high-risk patients [8] . Some meta-analyses report that placement of prophylactic pancreatic stents may lower the overall incidence of PEP in high-risk patients, but not the incidence of severe PEP [9] . Furthermore, some debate still exists regarding the use of indomethacin [10] .…”

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

“…Analyses of prospective trials have suggested benefit from PPS. [98][99][100][101] The number needed to treat to prevent one case of PEP is less than 10. More importantly, the risk of severe PEP is virtually abolished with PPS.…”

“…Finally and most concerning, about 5%-20% of attempted PPS fails and there can be substantial risk of PEP (35%-67%) associated with failed stent placement. 101,[111][112][113][114] From a meta-analysis, the risk of PEP after failed PPS placement was 19%. 101 Attempted but failed PPS stent placement is considered to have worse consequences in highrisk patients when compared to those not treated with pancreatic stents.…”

“…101,[111][112][113][114] From a meta-analysis, the risk of PEP after failed PPS placement was 19%. 101 Attempted but failed PPS stent placement is considered to have worse consequences in highrisk patients when compared to those not treated with pancreatic stents. 111 It is also possible that subtle technical details during placement may affect the success of PPS.…”