Acta Medica Okayama volume74 issue6
2020-12 発行

Prevention of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis by Endoscopic Pancreatic Stenting after Insertion of Self-Expandable Metal Stent for Malignant Distal Biliary Stricture

Harada, Ryo Department of Gastroenterology and Hepatology, Japanese Red Cross Okayama Hospital
Sato, Ryosuke Department of Gastroenterology and Hepatology, Japanese Red Cross Okayama Hospital
Tsutsui, Tomoaki Department of Gastroenterology and Hepatology, Japanese Red Cross Okayama Hospital
Hattori, Nao Department of Gastroenterology and Hepatology, Japanese Red Cross Okayama Hospital
Inoue, Masafumi Department of Gastroenterology and Hepatology, Japanese Red Cross Okayama Hospital
Kobashi, Haruhiko Department of Gastroenterology and Hepatology, Japanese Red Cross Okayama Hospital
Publication Date
2020-12
Abstract
The insertion of a self-expandable metal stent (SEMS) for nonpancreatic cancer is a factor predicting the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). We evaluated the efficacy of endo-scopic pancreatic stenting (EPS) to prevent PEP after SEMS insertion in patients with malignant distal biliary stricture and without main pancreatic duct (MPD) obstruction. We performed a single-center, retrospective, historically controlled investigation to assess the outcomes of 33 consecutive patients who underwent SEMS insertion. From March 2013 to June 2015, 13 patients did not undergo EPS (Non-EPS group). The other 20 patients underwent EPS (EPS group) between July 2015 and August 2018. The background data demonstrated no significant differences. Except for one patient in the Non-EPS group, all patients underwent biliary sphinc-terotomy. The EPS group’s PEP incidence was significantly lower (n = 1, 5%) than that of the Non-EPS group (n = 4, 31%) (p = 0.04). The median serum amylase and lipase levels after the procedure were significantly lower in the EPS group than in the Non-EPS group (amylase: 104 vs. 262 U/L; p < 0.01, lipase: 102 vs. 666 U/L; p = 0.01). The use of EPS decreased the incidence of PEP after SEMS insertion in individuals with malignant distal biliary stricture and without MPD obstruction.
Document Type
Original Article
Keywords
post-endoscopic retrograde cholangiopancreatography pancreatitis
endoscopic pancreatic stent
main pancreatic duct obstruction
self-expandable metal stent
distal biliary stricture
Link to PubMed