Pancreatic Stenting Reduces Post-ERCP Pancreatitis and Biliary Sepsis in High-Risk Patients: A Randomized, Controlled Study
Background. Endoscopic retrograde cholangiopancreatography (ERCP) is an established treatment modality for bile duct disorders, but patients have a risk of post-ERCP pancreatitis (PEP) and biliary sepsis. Aim. To evaluate the effectiveness and safety of pancreatic stent for prophylaxis of PEP and bi...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/9687052 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850226617652084736 |
|---|---|
| author | He-Kun Yin Hai-En Wu Qi-Xiang Li Wei Wang Wei-Lin Ou Harry Hua-Xiang Xia |
| author_facet | He-Kun Yin Hai-En Wu Qi-Xiang Li Wei Wang Wei-Lin Ou Harry Hua-Xiang Xia |
| author_sort | He-Kun Yin |
| collection | DOAJ |
| description | Background. Endoscopic retrograde cholangiopancreatography (ERCP) is an established treatment modality for bile duct disorders, but patients have a risk of post-ERCP pancreatitis (PEP) and biliary sepsis. Aim. To evaluate the effectiveness and safety of pancreatic stent for prophylaxis of PEP and biliary sepsis in high-risk patients with complicating common bile duct (CBD) disorders. Methods. Two hundred and six patients with complicating confirmed or suspected CBD disorders were randomly assigned to receive ERCP with pancreatic stenting (experimental group) or without stenting (control group). Primary outcome measure was frequency of PEP, and secondary outcome measures included operative time, blood loss, postoperative recovery times, and other ERCP-associated morbidities. Results. Baseline age, sex, CBD etiology, concomitant medical/surgical conditions, cannulation difficulty, and ERCP success were comparable between the two groups (all P>0.05). Compared to the control group, the experimental group had a significantly lower frequency of PEP (7.7% versus 17.7%, P<0.05) and positive bile microbial culture (40.4% versus 62.7%, P<0.05). However, the two groups were similar in operative time, blood loss, postoperative recovery times, and other ERCP-associated morbidities (all P>0.05). Conclusions. Pancreatic stenting can reduce the occurrence of PEP and biliary sepsis in high-risk patients with complicating CBD disorders but does not increase other ERCP-associated morbidities. This trial is registered with the Chinese Clinical Trial Registry (registration identifier ChiCTR-OCH-14005134). |
| format | Article |
| id | doaj-art-5ced4276f7be48e0b6a0a9a824d3f6ec |
| institution | OA Journals |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-5ced4276f7be48e0b6a0a9a824d3f6ec2025-08-20T02:05:01ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/96870529687052Pancreatic Stenting Reduces Post-ERCP Pancreatitis and Biliary Sepsis in High-Risk Patients: A Randomized, Controlled StudyHe-Kun Yin0Hai-En Wu1Qi-Xiang Li2Wei Wang3Wei-Lin Ou4Harry Hua-Xiang Xia5Department of Gastroenterology, Jiangmen Central Hospital, Jiangmen, Guangdong, ChinaDepartment of Gastroenterology, Jiangmen Central Hospital, Jiangmen, Guangdong, ChinaDepartment of Gastroenterology, Jiangmen Central Hospital, Jiangmen, Guangdong, ChinaDepartment of Gastroenterology, Jiangmen Central Hospital, Jiangmen, Guangdong, ChinaDepartment of Gastroenterology, Jiangmen Central Hospital, Jiangmen, Guangdong, ChinaDepartment of Gastroenterology, The First Hospital Affiliated to Guangdong Pharmaceutical University, Guangzhou, Guangdong, ChinaBackground. Endoscopic retrograde cholangiopancreatography (ERCP) is an established treatment modality for bile duct disorders, but patients have a risk of post-ERCP pancreatitis (PEP) and biliary sepsis. Aim. To evaluate the effectiveness and safety of pancreatic stent for prophylaxis of PEP and biliary sepsis in high-risk patients with complicating common bile duct (CBD) disorders. Methods. Two hundred and six patients with complicating confirmed or suspected CBD disorders were randomly assigned to receive ERCP with pancreatic stenting (experimental group) or without stenting (control group). Primary outcome measure was frequency of PEP, and secondary outcome measures included operative time, blood loss, postoperative recovery times, and other ERCP-associated morbidities. Results. Baseline age, sex, CBD etiology, concomitant medical/surgical conditions, cannulation difficulty, and ERCP success were comparable between the two groups (all P>0.05). Compared to the control group, the experimental group had a significantly lower frequency of PEP (7.7% versus 17.7%, P<0.05) and positive bile microbial culture (40.4% versus 62.7%, P<0.05). However, the two groups were similar in operative time, blood loss, postoperative recovery times, and other ERCP-associated morbidities (all P>0.05). Conclusions. Pancreatic stenting can reduce the occurrence of PEP and biliary sepsis in high-risk patients with complicating CBD disorders but does not increase other ERCP-associated morbidities. This trial is registered with the Chinese Clinical Trial Registry (registration identifier ChiCTR-OCH-14005134).http://dx.doi.org/10.1155/2016/9687052 |
| spellingShingle | He-Kun Yin Hai-En Wu Qi-Xiang Li Wei Wang Wei-Lin Ou Harry Hua-Xiang Xia Pancreatic Stenting Reduces Post-ERCP Pancreatitis and Biliary Sepsis in High-Risk Patients: A Randomized, Controlled Study Gastroenterology Research and Practice |
| title | Pancreatic Stenting Reduces Post-ERCP Pancreatitis and Biliary Sepsis in High-Risk Patients: A Randomized, Controlled Study |
| title_full | Pancreatic Stenting Reduces Post-ERCP Pancreatitis and Biliary Sepsis in High-Risk Patients: A Randomized, Controlled Study |
| title_fullStr | Pancreatic Stenting Reduces Post-ERCP Pancreatitis and Biliary Sepsis in High-Risk Patients: A Randomized, Controlled Study |
| title_full_unstemmed | Pancreatic Stenting Reduces Post-ERCP Pancreatitis and Biliary Sepsis in High-Risk Patients: A Randomized, Controlled Study |
| title_short | Pancreatic Stenting Reduces Post-ERCP Pancreatitis and Biliary Sepsis in High-Risk Patients: A Randomized, Controlled Study |
| title_sort | pancreatic stenting reduces post ercp pancreatitis and biliary sepsis in high risk patients a randomized controlled study |
| url | http://dx.doi.org/10.1155/2016/9687052 |
| work_keys_str_mv | AT hekunyin pancreaticstentingreducespostercppancreatitisandbiliarysepsisinhighriskpatientsarandomizedcontrolledstudy AT haienwu pancreaticstentingreducespostercppancreatitisandbiliarysepsisinhighriskpatientsarandomizedcontrolledstudy AT qixiangli pancreaticstentingreducespostercppancreatitisandbiliarysepsisinhighriskpatientsarandomizedcontrolledstudy AT weiwang pancreaticstentingreducespostercppancreatitisandbiliarysepsisinhighriskpatientsarandomizedcontrolledstudy AT weilinou pancreaticstentingreducespostercppancreatitisandbiliarysepsisinhighriskpatientsarandomizedcontrolledstudy AT harryhuaxiangxia pancreaticstentingreducespostercppancreatitisandbiliarysepsisinhighriskpatientsarandomizedcontrolledstudy |