Small prophylactic pancreatic duct stents: an assessment of spontaneous passage and stent-induced ductal abnormalities

Abstract

Nearly 90 % of prophylactic 3-Fr pancreatic duct stents pass spontaneously within 30 days, and these stents were not observed to induce changes in the pancreatic duct.

Complications of ERCP

“…[86][87][88] PD stent size, composition, and duration of placement may all influence the incidence of these changes, which are not clinically relevant in all cases. 89 …”

Prophylactic Pancreatic Stents: Does Size Matter? A Comparison of 4-Fr and 5-Fr Stents in Reference to Post-ERCP Pancreatitis and Migration Rate

“…The higher spontaneous migration rate with 4-Fr stents reduces the need for repeat endoscopy and the associated added cost and inconvenience to the patient, and may reduce the potential risk of pancreatic duct injury associated with the presence of the stent in the pancreatic duct. Smaller stents such as the 3-Fr stents have several reported advantages including higher rate of migration, lower rate of post-ERCP pancreatitis, and less ductal changes [8]. Despite their advantages, the smaller 3-Fr stents are not widely used because they require the use of an additional 0.018-inch guidewire, a wire that is more challenging to work with, adding to the difficulty and cost of the procedure.…”

“…Limited data suggest that approximately 75% of the PPS migrate out spontaneously [7]. This rate is dependent on stent size with migration rates up to 90% seen with 3-Fr stents [8]. Spontaneous stent migration into the duodenum obviates the need for endoscopy for stent removal and reduces medical expenses and patient inconvenience.…”

Rescue ERCP and insertion of a small-caliber pancreatic stent to prevent the evolution of severe post-ERCP pancreatitis: a case-controlled series

“…Although optimal duration of the rescue pancreatic stenting is not yet clear in the literature, major concern has recently emerged about spontaneous passage and prophylactic stent-induced ductal abnormalities in these patients [21]. We prefer prophylactic stents with no or minimal tendency for spontaneous dislodgement, since we want to be sure that our stent will be kept in position during the initial and risky 72 h after ERCP and EST in order to drain the pancreatic duct effectively.…”