Document Detail

Feasibility and safety of emergency ERCP and small-caliber pancreatic stenting as a bridging procedure in patients with acute biliary pancreatitis but difficult sphincterotomy.
MedLine Citation:
PMID:  20108145     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aims of the present study were: (1) to assess the feasibility and safety of emergency endoscopic retrograde cholangiopancreatography (ERCP) and pancreatic duct (PD) stenting with small-caliber stents as a bridging procedure in acute biliary pancreatitis (ABP) patients in whom biliary endoscopic sphincterotomy (EST) proved difficult, failed or was contraindicated, and (2) to compare the clinical outcome of those patients having emergency ERCP with and without pancreatic stent. METHOD: Eighty-seven consecutive patients with ABP were referred for emergency ERCP. In 60 of these ABP patients, ERCP, EST, and stone extraction (if necessary) were performed without PD stenting. In the remaining 27 patients, small-caliber (3-5 F, 4 cm) pancreatic stent insertion was initially applied. All patients were hospitalized for medical therapy and were followed up. RESULTS: The mean ages, the initial symptom-to-ERCP times, the Glasgow severity scores, and the peak amylase and CRP levels at initial presentation were not significantly different in the ERCP + EST with PD stent group versus the ERCP + EST without PD stent group. More importantly, the complication rate was significantly lower in the ERCP + EST with PD stent group versus the ERCP + EST without PD stent group (7.4% vs. 25%); while the mortality rates (0% vs. 6.7%) were comparable, reasonably low, and demonstrated no statistically significant differences. CONCLUSIONS: Temporary PD stenting with small-caliber stents is a safe and effective procedure that may afford sufficient PD decompression to reverse the process of ABP and serve as a bridging procedure in severe ABP in patients with failed, complicated, or contraindicated biliary EST.
Roland Fejes; Gábor Kurucsai; András Székely; Iván Székely; Aron Altorjay; László Madácsy
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Publication Detail:
Type:  Journal Article     Date:  2010-01-28
Journal Detail:
Title:  Surgical endoscopy     Volume:  24     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1878-85     Citation Subset:  IM    
Department of Gastroenterology and Endoscopy Unit, Fejér Megyei Szent György Hospital, Seregélyesi 3, Székesfehérvár, 8000, Hungary.
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MeSH Terms
Acute Disease
Cholangiopancreatography, Endoscopic Retrograde* / methods
Emergency Treatment*
Feasibility Studies
Middle Aged
Pancreatitis / surgery*
Prospective Studies
Prosthesis Design
Single-Blind Method
Sphincterotomy, Endoscopic

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