Pancreatic Stents for Prevention of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Freeman, Martin L.

doi:10.1016/j.cgh.2007.09.007

Cited by 197 publications

(171 citation statements)

References 65 publications

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“…Although great decreases in the incidence of PEP have been shown by pancreatic stents in high risk patients, these studies, however, are heterogeneous in study design and characteristics of the stent and may draw definitive conclusions (3,(19)(20). Moreover, the placement of a stent is expensive and requires an experienced endoscopist for an appropriate insertion.…”

Section: Discussionmentioning

confidence: 99%

Rectal indomethacin for the prevention of post-ERCP pancreatitis: A meta-analysis of randomized controlled trials

Shi¹,

Deng²,

Altaf³

et al. 2015

Turk J Gastroenterol

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Background/Aims: This meta-analysis was undertaken to evaluate the effect of rectal indomethacin in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Materials and Methods: Major databases including Embase, Medline, Science Citation Index Expanded, Pubmed and the Cochrane Central Register of Controlled Trials, were searched to identify all relevant studies from January 1960 to July 2013. Randomized controlled trials (RCTs) comparing prophylactic use of rectal indomethacin versus placebo were included. Risk ratio (RR) with 95% confidence interval (CI) was calculated using fixed-or randomeffect models. Results: Three studies met the inclusion criteria and were included in the final analyses. The overall incidence of post-ERCP pancreatitis (PEP) was significantly decreased by prophylactic rectal indomethacin compared with the placebo (RR=0.51; 95% CI=0.37-0.70). The pooled incidence of moderate to severe pancreatitis was also decreased by rectal indomethacin prophylaxis (RR=0.43; 95% CI=0.23-0.80). Conclusion: Rectal indomethacin can reduce the overall incidence and the severity of PEP.

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Section: Discussionmentioning

confidence: 99%

Rectal indomethacin for the prevention of post-ERCP pancreatitis: A meta-analysis of randomized controlled trials

Shi¹,

Deng²,

Altaf³

et al. 2015

Turk J Gastroenterol

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“…Due to their variability in indications for stenting, interventions and outcome measures -comparisons and conclusions can be difficult. A few trials have shown that pancreatic stent insertion reduces the rate and severity of post-ERCP pancreatitis after difficult cannulation, needle-knife precut, biliary sphincterotomy for sphincter of Oddi dysfunction (SOD) and manometry, pancreatic sphincterotomy, endoscopic ampullectomy and endoscopic balloon dilation [26][27][28][29][30][31][32][33] .…”

Section: Ercp Techniquementioning

confidence: 99%

Prevention of post-ERCP pancreatitis

Wong

Tsai

2014

WJGP

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Post-procedure pancreatitis is the most common complication of endoscopic retrograde cholangio pancreatography (ERCP) and carries a high morbidity and mortality occurring in at least 3%-5% of all procedures. We reviewed the available literature searching for "ERCP" and "pancreatitis" and "post-ERCP pancreatitis". in PubMed and Medline. This review looks at the diagnosis, risk factors, causes and methods of preventing post-procedure pancreatitis. These include the evidence for patient selection, endoscopic techniques and pharmacological prophylaxis of ERCP induced pancreatitis. Selecting the right patient for the procedure by a risk benefits assessment is the best way of avoiding unnecessary ERCPs. Risk is particularly high in young women with sphincter of Oddi dysfunction (SOD). Many of the trials reviewed have rather few numbers of subjects and hence difficult to appraise. Meta-analyses have helped screen for promising modalities of prophylaxis. At present, evidence is emerging that pancreatic stenting of patients with SOD and rectally administered nonsteroidal anti-inflammatory drugs in a large unselected trial reduce the risk of post-procedure pancreatitis. A recent meta-analysis have demonstrated that rectally administered indomethecin, just before or after ERCP is associated with significantly lower rate of pancreatitis compared with placebo [OR = 0.49 (0.34-0.71); P = 0.0002]. Number needed to treat was 20. It is likely that one of these prophylactic measures will begin to be increasingly practised in high risk groups.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved. Key words: Acute pancreatitis; Endoscopic retrograde cholangio pancreatographyCore tip: Select patients carefully, and give high risk patients rectal indomethacin.Wong LL, Tsai HH. Prevention of post-ERCP pancreatitis.

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“…Although its prophylactic effect is well recognized, it may require a separate endoscopy to remove the stent in case of displacement , thus increasing the chance of tissue damage. Experts agreed that in view of pancreatic stenting, we should take the decision more cautiously (Freeman, 2007).…”

Section: Discussionmentioning

confidence: 99%

Proximal Migration of Pancreatic Stent A Case Report and Recommendations

Pan¹

2014

IJB

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Background: Pancreatic stents are commonly used in the treatment of pancreatic diseases but can cause many complications, including proximal migration. Case Report: We report a case of a proximally migrated pancreatic stent and how by using duodenal biopsy forceps we successfully removed the shifted stent. Conclusions: Pancreatic stenting requires high technical skills and the choice of the right stent is a very crucial in the success of the procedure. Once the stent is shifted, biopsy forceps can be used to remove the pancreatic duct stent.

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Pancreatic Stents for Prevention of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Cited by 197 publications

References 65 publications

Rectal indomethacin for the prevention of post-ERCP pancreatitis: A meta-analysis of randomized controlled trials

Rectal indomethacin for the prevention of post-ERCP pancreatitis: A meta-analysis of randomized controlled trials

Prevention of post-ERCP pancreatitis

Proximal Migration of Pancreatic Stent A Case Report and Recommendations

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