Impact of pancreatic and biliary stent on post-endoscopic papillectomy complications: A single-center retrospective study.
Chin Med J (Engl)
; 137(17): 2111-2118, 2024 Sep 05.
Article
in En
| MEDLINE
| ID: mdl-38809090
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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Stents
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Chin Med J (Engl)
Year:
2024
Type:
Article
Affiliation country:
China