Impact of pancreatic and biliary stent on post-endoscopic papillectomy complications: A single-center retrospective study
10.1097/CM9.0000000000002893
- VernacularTitle:Impact of pancreatic and biliary stent on post-endoscopic papillectomy complications: A single-center retrospective study
- Author:
Nan RU
1
;
Ningli CHAI
;
Bo ZHANG
;
Longsong LI
;
Yawei BI
;
Enqiang LINGHU
Author Information
1. Department of Gastroenterology, The First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
- Keywords:
Endoscopic papillectomy;
Complications;
Preventive measures;
Pancreatitis;
Hemorrhage
- From:
Chinese Medical Journal
2024;137(17):2111-2118
- CountryChina
- Language:Chinese
-
Abstract:
Background::Endoscopic papillectomy (EP) is recommended as the first-line therapy for ampullary tumors, despite a relatively high incidence of complications. Pancreatic and/or biliary stents are placed at the endoscopist’s discretion to prevent post-EP complications. The present study aimed to evaluate the efficacy of different stents.Methods::A total of 117 patients who underwent EP and met the criteria between June 2006 and October 2022 were enrolled in the study. These patients were divided into a pancreatic stent group (PS group, n = 47), a biliary stent group (BS group, n = 38), and a two-stent group (PBS [PS and BS] group, n = 32). Relevant clinical data were collected and compared among the three groups. Multivariate logistic analyses were performed to explore risk factors for post-EP complications. Results::The incidence of all complications was 37.6% (44/117). Pancreatitis and hemorrhage were the two most common complications with incidence rates of 14.5% (17/117) and 17.9% (21/117). The incidence rates of post-EP pancreatitis were 10.6% (5/47), 23.7% (9/38), and 9.4% (3/32) in the PS group, BS group, and PBS group, respectively, with no significant differences. There were also no significant differences in other complications among the three groups. Age (odds ratio [OR]: 0.95; 95% confidence interval [CI]: 0.91-0.99; P = 0.022) was independently associated with post-EP pancreatitis while tumor size (OR: 1.66; 95% CI: 1.06-2.60; P = 0.028) was independently associated with post-EP hemorrhage. Conclusions::While pancreatic stenting is the first choice to prevent post-EP pancreatitis, biliary stenting could also be considered as a substitute for patients with difficulties in pancreatic cannulation. Two-stent (biliary and pancreatic stent) placement is unnecessary unless it is required due to other concerns.
