Tsuchiya Takayoshi, Itoi Takao, Sofuni Atsushi, Itokawa Fumihide, Kurihara Toshio, Ishii Kentaro, Tsuji Syujiro, Kawai Takashi, Moriyasu Fuminori
Division of Gastroenterology, Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Tokyo 160-0023, Japan.
J Hepatobiliary Pancreat Surg. 2007;14(3):302-7. doi: 10.1007/s00534-006-1147-8. Epub 2007 May 29.
Post endoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis is the most common complication of ERCP, which can occasionally become serious or fatal. This preliminary study was to prospectively evaluate the efficacy of a temporary unflanged pancreatic duct stent (PS) to prevent post-ERCP pancreatitis.
A total of 64 patients were randomly divided into a control group, which did not undergo stenting, and a stent group. The stent used was a 5-Fr pigtail PS without an inner flange.
Placement of an unflanged PS was successful and without complications in all 32 patients. The rates of hyperamylasemia were 50.0% and 34.4% in the control and stent groups, respectively (P > 0.05), and the mean serum amylase levels were 456.2 and 257.9 IU/l, respectively (P = 0.035). The overall rates of post-ERCP pancreatitis diagnosed according to Cotton's criteria were 12.5% and 3.1% in the control and stent groups, respectively (P > 0.05). The severity of pancreatitis was severe in one patient, moderate in one, and mild in two in the control group, whereas in the stent group, the single case of pancreatitis was mild.
Placement of an unflanged 5-Fr PS may be useful in preventing post-ERCP pancreatitis.
内镜逆行胰胆管造影术后胰腺炎是内镜逆行胰胆管造影最常见的并发症，偶尔会变得严重或致命。这项初步研究旨在前瞻性评估临时无侧翼胰管支架（PS）预防内镜逆行胰胆管造影术后胰腺炎的疗效。
总共64例患者被随机分为未进行支架置入的对照组和支架组。使用的支架是一种没有内翼缘的5F猪尾PS。
在所有32例患者中，无侧翼PS的置入均成功且无并发症。对照组和支架组的高淀粉酶血症发生率分别为50.0%和34.4%（P>0.05），血清淀粉酶平均水平分别为456.2和257.9 IU/L（P=0.035）。根据Cotton标准诊断的内镜逆行胰胆管造影术后胰腺炎总体发生率在对照组和支架组中分别为12.5%和3.
