Prophylactic Efficacy of 3- or 5-cm Pancreatic Stents for Preventing Post-ERCP Pancreatitis: A Prospective, Randomized Trial
| Autor: | Kantaro Hisatomi, Koichi Kagawa, Atsushi Nakajima, Kensuke Kubota, Kazushige Ochiai, Hajime Sato, Nobuyuki Matsuhashi, Toshio Fujisawa |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment education Prosthesis Design law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Medicine Humans Prospective Studies Prospective cohort study Aged Cholangiopancreatography Endoscopic Retrograde Intention-to-treat analysis business.industry Gastroenterology Pancreatic Ducts Stent Jaundice equipment and supplies medicine.disease Surgery Intention to Treat Analysis Prosthesis Failure Jaundice Obstructive Choledocholithiasis Pancreatitis 030220 oncology & carcinogenesis cardiovascular system Pancreatic stents 030211 gastroenterology & hepatology Female Stents medicine.symptom business Post ercp pancreatitis circulatory and respiratory physiology |
| Zdroj: | Journal of clinical gastroenterology. 50(3) |
| ISSN: | 1539-2031 |
| Popis: | Prophylactic pancreatic stent placement is effective for preventing postendoscopic retrograde cholangiopancreatography pancreatitis (PEP). The most effective type of stent, however, remains unclear. Therefore, we prospectively compared the prophylactic efficacy for PEP prevention between short (3 cm) and long (5 cm) pancreatic stent.Between July 2012 and June 2014, 240 consecutive patients requiring therapeutic endoscopic retrograde cholangiopancreatography to remove a choledocholith or for bile drainage for obstructive jaundice were prospectively enrolled and randomized to undergo prophylactic insertion with unflanged, 5 Fr, 3 or 5-cm pancreatic stent. An efficacy of each stent for preventing PEP was evaluated as a primary endpoint. The period until stent dislodgement and the total adverse event rate were also evaluated as a secondary endpoint.Per-protocol analysis revealed that the PEP rate was significantly lower with the short stent than with the long stent (2.0% vs. 8.8%, P=0.035), although they were not significantly different in intention-to-treat analysis. The adverse event rate excluding PEP did not differ significantly between groups (3.0% vs. 0.9%, P=0.293). The median period until dislodgement of the short stent was significantly shorter than that of the long stent (2 vs. 4 d, P0.001).The present study revealed a superiority of 3-cm stents compared with 5-cm stents for prophylactic pancreatic stent. On the basis of the past reports and the result of the present study, we recommend using a 5 Fr, 3-cm unflanged stent.This study was registered on the UMIN Clinical Trial Registry (UMIN000008290). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|