Early precut is as efficient as pancreatic stent in preventing post-ERCP pancreatitis in high-risk subjects: a randomized study
Background: The most common adverse event of endoscopic retrograde cholangiopancreatography is pancreatitis. Precut sphincterotomy has been regarded as a risk factor. Some authors have stated that early precut may actually reduce post-ERCP pancreatitis risk. However, early precut as a preventive mea...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Aran Ediciones
|
Series: | Revista Espanola de Enfermedades Digestivas |
Subjects: | |
Online Access: | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000900005&lng=en&tlng=en |
id |
doaj-a84ac1eeea534896aa9436746e2770a5 |
---|---|
record_format |
Article |
spelling |
doaj-a84ac1eeea534896aa9436746e2770a52020-11-24T22:22:15ZengAran EdicionesRevista Espanola de Enfermedades Digestivas1130-0108108955856210.17235/reed.2016.4348/2016S1130-01082016000900005Early precut is as efficient as pancreatic stent in preventing post-ERCP pancreatitis in high-risk subjects: a randomized studyDavid Zagalsky0Martín Guidi1Cecilia Curvale2Juan Lasa3Julio de María4Hernán Ianniccillo5Hui Jer Hwang6Raúl Matano7Hospital Nacional Profesor Alejandro PosadasHospital El CruceHospital El CruceHospital Nacional Profesor Alejandro PosadasHospital El CruceHospital Nacional Profesor Alejandro PosadasHospital El CruceHospital El CruceBackground: The most common adverse event of endoscopic retrograde cholangiopancreatography is pancreatitis. Precut sphincterotomy has been regarded as a risk factor. Some authors have stated that early precut may actually reduce post-ERCP pancreatitis risk. However, early precut as a preventive measure has not been compared to other preventive measures, such as pancreatic duct stent placement. Aim: To compare the efficacy of early precut sphincterotomy versus pancreatic duct stent placement in high-risk subjects undergoing endoscopic retrograde cholangiopancreatography for the prevention of post-endoscopic cholangiopancreatography. Materials and Methods: This was a single-blinded, randomized trial that took place in two tertiary referral centers in Buenos Aires, from November 2011 to December 2013. ERCP subjects presented at least one of the following risk factors: female sex, age less than 40 years, clinical suspicion of sphincter of Oddi dysfunction, previous pancreatitis, and/or common bile duct diameter of less than 8 mm. Only those who presented a difficult biliary cannulation were randomized into two groups: those who received early precut sphincterotomy and those in whom persistency of biliary cannulation was intended, with subsequent pancreatic duct stent placement after cholangiography was achieved. The incidence of post-ERCP pancreatitis, as well as other adverse events incidence, was compared. Results: Overall, 101 patients were enrolled, 51 in the pancreatic duct stent group and 50 in the early precut group. Pancreatitis rate was similar in both groups (3.92% vs. 4%, p NS). In all cases, pancreatitis was classified as mild. There were no deaths registered. Conclusion: Early precut was associated with an incidence of adverse events similar to pancreatic duct stent placement.http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000900005&lng=en&tlng=enPrecutPancreatic stentPancreatitisERCP |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David Zagalsky Martín Guidi Cecilia Curvale Juan Lasa Julio de María Hernán Ianniccillo Hui Jer Hwang Raúl Matano |
spellingShingle |
David Zagalsky Martín Guidi Cecilia Curvale Juan Lasa Julio de María Hernán Ianniccillo Hui Jer Hwang Raúl Matano Early precut is as efficient as pancreatic stent in preventing post-ERCP pancreatitis in high-risk subjects: a randomized study Revista Espanola de Enfermedades Digestivas Precut Pancreatic stent Pancreatitis ERCP |
author_facet |
David Zagalsky Martín Guidi Cecilia Curvale Juan Lasa Julio de María Hernán Ianniccillo Hui Jer Hwang Raúl Matano |
author_sort |
David Zagalsky |
title |
Early precut is as efficient as pancreatic stent in preventing post-ERCP pancreatitis in high-risk subjects: a randomized study |
title_short |
Early precut is as efficient as pancreatic stent in preventing post-ERCP pancreatitis in high-risk subjects: a randomized study |
title_full |
Early precut is as efficient as pancreatic stent in preventing post-ERCP pancreatitis in high-risk subjects: a randomized study |
title_fullStr |
Early precut is as efficient as pancreatic stent in preventing post-ERCP pancreatitis in high-risk subjects: a randomized study |
title_full_unstemmed |
Early precut is as efficient as pancreatic stent in preventing post-ERCP pancreatitis in high-risk subjects: a randomized study |
title_sort |
early precut is as efficient as pancreatic stent in preventing post-ercp pancreatitis in high-risk subjects: a randomized study |
publisher |
Aran Ediciones |
series |
Revista Espanola de Enfermedades Digestivas |
issn |
1130-0108 |
description |
Background: The most common adverse event of endoscopic retrograde cholangiopancreatography is pancreatitis. Precut sphincterotomy has been regarded as a risk factor. Some authors have stated that early precut may actually reduce post-ERCP pancreatitis risk. However, early precut as a preventive measure has not been compared to other preventive measures, such as pancreatic duct stent placement. Aim: To compare the efficacy of early precut sphincterotomy versus pancreatic duct stent placement in high-risk subjects undergoing endoscopic retrograde cholangiopancreatography for the prevention of post-endoscopic cholangiopancreatography. Materials and Methods: This was a single-blinded, randomized trial that took place in two tertiary referral centers in Buenos Aires, from November 2011 to December 2013. ERCP subjects presented at least one of the following risk factors: female sex, age less than 40 years, clinical suspicion of sphincter of Oddi dysfunction, previous pancreatitis, and/or common bile duct diameter of less than 8 mm. Only those who presented a difficult biliary cannulation were randomized into two groups: those who received early precut sphincterotomy and those in whom persistency of biliary cannulation was intended, with subsequent pancreatic duct stent placement after cholangiography was achieved. The incidence of post-ERCP pancreatitis, as well as other adverse events incidence, was compared. Results: Overall, 101 patients were enrolled, 51 in the pancreatic duct stent group and 50 in the early precut group. Pancreatitis rate was similar in both groups (3.92% vs. 4%, p NS). In all cases, pancreatitis was classified as mild. There were no deaths registered. Conclusion: Early precut was associated with an incidence of adverse events similar to pancreatic duct stent placement. |
topic |
Precut Pancreatic stent Pancreatitis ERCP |
url |
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000900005&lng=en&tlng=en |
work_keys_str_mv |
AT davidzagalsky earlyprecutisasefficientaspancreaticstentinpreventingpostercppancreatitisinhighrisksubjectsarandomizedstudy AT martinguidi earlyprecutisasefficientaspancreaticstentinpreventingpostercppancreatitisinhighrisksubjectsarandomizedstudy AT ceciliacurvale earlyprecutisasefficientaspancreaticstentinpreventingpostercppancreatitisinhighrisksubjectsarandomizedstudy AT juanlasa earlyprecutisasefficientaspancreaticstentinpreventingpostercppancreatitisinhighrisksubjectsarandomizedstudy AT juliodemaria earlyprecutisasefficientaspancreaticstentinpreventingpostercppancreatitisinhighrisksubjectsarandomizedstudy AT hernanianniccillo earlyprecutisasefficientaspancreaticstentinpreventingpostercppancreatitisinhighrisksubjectsarandomizedstudy AT huijerhwang earlyprecutisasefficientaspancreaticstentinpreventingpostercppancreatitisinhighrisksubjectsarandomizedstudy AT raulmatano earlyprecutisasefficientaspancreaticstentinpreventingpostercppancreatitisinhighrisksubjectsarandomizedstudy |
_version_ |
1725769204125138944 |