Evaluation of post-ERCP pancreatitis after biliary stenting with self-expandable metal stents vs. plastic stents in benign and malignant obstructions
| Title: | Evaluation of post-ERCP pancreatitis after biliary stenting with self-expandable metal stents vs. plastic stents in benign and malignant obstructions |
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| Authors: | Nichol S. Martinez, Sumant Inamdar, Sheila N. Firoozan, Stephanie Izard, Calvin Lee, Petros C. Benias, Arvind J. Trindade, Divyesh V. Sejpal |
| Source: | Endoscopy International Open, Vol 09, Iss 06, Pp E888-E894 (2021) |
| Publisher Information: | Georg Thieme Verlag KG, 2021. |
| Publication Year: | 2021 |
| Collection: | LCC:Diseases of the digestive system. Gastroenterology |
| Subject Terms: | Diseases of the digestive system. Gastroenterology, RC799-869 |
| More Details: | Background and study aims There are conflicting data regarding the risk of post-ERCP pancreatitis (PEP) with self-expandable metallic stents (SEMS) compared to polyethylene stents (PS) in malignant biliary obstructions and limited data related to benign obstructions. Patients and methods A retrospective cohort study was performed of 1136 patients who underwent ERCP for biliary obstruction and received SEMS or PS at a tertiary-care medical center between January 2011 and October 2016. We evaluated the association between stent type (SEMS vs PS) and PEP in malignant and benign biliary obstructions. Results Among the 1136 patients included in our study, 399 had SEMS placed and 737 had PS placed. Patients with PS were more likely to have pancreatic duct cannulation, pancreatic duct stent placement, double guidewire technique, sphincterotomy and sphincteroplasty as compared to the SEMS group. On multivariate analysis, PEP rates were higher in the SEMS group (8.0 %) versus the PS group (4.8 %) (OR 2.27 [CI, 1.22, 4.24]) for all obstructions. For malignant obstructions, PEP rates were 7.8 % and 6.6 % for SEMS and plastic stents, respectively (OR 1.54 [CI, 0.72, 3.30]). For benign obstructions the PEP rate was higher in the SEMS group (8.8 %) compared to the PS group (4.2 %) (OR 3.67 [CI, 1.50, 8.97]). No significant differences between PEP severity were identified based on stent type when stratified based on benign and malignant. Conclusions PEP rates were higher when SEMS were used for benign obstruction as compared to PS. For malignant obstruction, no difference was identified in PEP rates with use of SEMS vs PS. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2364-3722 2196-9736 |
| Relation: | https://doaj.org/toc/2364-3722; https://doaj.org/toc/2196-9736 |
| DOI: | 10.1055/a-1388-6964 |
| Access URL: | https://doaj.org/article/ce4165d13013415fb1dd4ae25cc56123 |
| Accession Number: | edsdoj.4165d13013415fb1dd4ae25cc56123 |
| Database: | Directory of Open Access Journals |
| ISSN: | 23643722 21969736 |
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| DOI: | 10.1055/a-1388-6964 |
| Published in: | Endoscopy International Open |
| Language: | English |