Randomized controlled trial of pancreatic stenting to prevent pancreatitis after endoscopic retrograde cholangiopancreatography

作     者：Yoshiaki Kawaguchi Masami Ogawa Fumio Omata Hiroyuki Ito Tooru Shimosegawa Tetsuya Mine 

作者机构：Division of GastroenterologyTokai University School of MedicineIsehara 259-1193Japan Division of GastroenterologyTohoku University Graduate School of Medicine1-1 Seiryo-machiAobakuSendai CityMiyagi 980-8574Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2012年第18卷第14期

页      面：1635-1641页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Endoscopic retrograde cholangiopancreatography Pancreatitis Postoperative complications Prophylaxis Stents 

摘      要：AIM:To determine the effectiveness of pancreatic duct(PD) stent placement for the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP) in high risk ***:Authors conducted a single-blind,randomized controlled trial to evaluate the effectiveness of a pancreatic spontaneous dislodgement stent against post-ERCP pancreatitis,including rates of spontaneous dislodgement and *** defined high risk patients as having any of the following:sphincter of Oddi dysfunction,difficult cannulation,prior history of post-ERCP pancreatitis,pre-cut sphincterotomy,pancreatic ductal biopsy,pancreatic sphincterotomy,intraductal ultrasonography,or a procedure time of more than 30 *** were randomized to a stent group(n = 60) or to a non-stent group(n = 60).An abdominal radiograph was obtained daily to assessspontaneous stent ***-ERCP pancreatitis was diagnosed according to consensus ***:The mean age(± standard deviation) was 67.4 ± 13.8 years and the male:female ratio was 68:*** the stent group,the mean age was 66 ± 13 years and the male:female ratio was 33:27,and in the non-stent group,the mean age was 68 ± 14 years and the male:female ratio was 35:*** were no significant differences between groups with respect to age,gender,final diagnosis,or type of endoscopic *** frequency of post-ERCP pancreatitis in PD stent and non-stent groups was 1.7%(1/60) and 13.3%(8/60),*** severity of pancreatitis was mild in all *** frequency of post-ERCP pancreatitis in the stent group was significantly lower than in the non-stent group(P = 0.032,Fisher s exact test).The rate of hyperamylasemia were 30%(18/60) and 38.3%(23 of 60) in the stent and non-stent groups,respectively(P = 0.05,χ2 test).The placement of a PD stent was successful in all 60 *** rate of spontaneous dislodgement by the third day was 96.7%(58/60),and the median(range) time to dislodgement was 2.1(2-