Does prophylactic pancreatic stent placement reduce the risk of post-ERCP acute pancreatitis? a meta-analysis of controlled trials

Pankaj Singh, Ananya Das, Gerard Isenberg, Richard C K Wong, Michael V. Sivak, Deepak Agrawal, Amitabh Chak

Research output: Contribution to journalArticle

264 Citations (Scopus)

Abstract

Background: Impaired drainage of the pancreatic duct is one of the possible triggers for post-ERCP acute pancreatitis. The aim of this meta-analysis was to determine whether temporary stent placement across the main pancreatic-duct orifice lowers the frequency of post-ERCP acute pancreatitis in patients at high risk for this complication. Methods: Two reviewers systematically identified prospective studies that (1) compared the risk of post-ERCP acute pancreatitis in patients with pancreatic stent placement vs. no stent placement and (2) included patients at high risk of developing this complication. Studies were assessed for methodologic quality and variations in execution and design. Frequency and severity of post-ERCP acute pancreatitis were the primary outcomes evaluated. Results: Five trials involving 481 patients were selected. Of the 481, 55 (11.4%) patients developed pancreatitis after ERCP. Patients in the no stent group had 3-fold higher odds of developing pancreatitis compared with the stent group (15.5% vs. 5.8%; OR 3.2: 95% CI[1.6, 6.4]). Number needed to treat analysis showed that one in every 10 patients (95% CI[6,18]) could be expected to benefit from pancreatic-duct stent placement. Conclusions: Prophylactic temporary stent placement across the main pancreatic-duct orifice reduces the risk of post-ERCP acute pancreatitis in patients at risk for developing this complication.

Original languageEnglish (US)
Pages (from-to)544-550
Number of pages7
JournalGastrointestinal Endoscopy
Volume60
Issue number4
DOIs
StatePublished - Oct 2004

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Endoscopic Retrograde Cholangiopancreatography
Pancreatitis
Stents
Meta-Analysis
Pancreatic Ducts
Numbers Needed To Treat
Drainage
Prospective Studies

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Does prophylactic pancreatic stent placement reduce the risk of post-ERCP acute pancreatitis? a meta-analysis of controlled trials. / Singh, Pankaj; Das, Ananya; Isenberg, Gerard; Wong, Richard C K; Sivak, Michael V.; Agrawal, Deepak; Chak, Amitabh.

In: Gastrointestinal Endoscopy, Vol. 60, No. 4, 10.2004, p. 544-550.

Research output: Contribution to journalArticle

Singh, Pankaj ; Das, Ananya ; Isenberg, Gerard ; Wong, Richard C K ; Sivak, Michael V. ; Agrawal, Deepak ; Chak, Amitabh. / Does prophylactic pancreatic stent placement reduce the risk of post-ERCP acute pancreatitis? a meta-analysis of controlled trials. In: Gastrointestinal Endoscopy. 2004 ; Vol. 60, No. 4. pp. 544-550.
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abstract = "Background: Impaired drainage of the pancreatic duct is one of the possible triggers for post-ERCP acute pancreatitis. The aim of this meta-analysis was to determine whether temporary stent placement across the main pancreatic-duct orifice lowers the frequency of post-ERCP acute pancreatitis in patients at high risk for this complication. Methods: Two reviewers systematically identified prospective studies that (1) compared the risk of post-ERCP acute pancreatitis in patients with pancreatic stent placement vs. no stent placement and (2) included patients at high risk of developing this complication. Studies were assessed for methodologic quality and variations in execution and design. Frequency and severity of post-ERCP acute pancreatitis were the primary outcomes evaluated. Results: Five trials involving 481 patients were selected. Of the 481, 55 (11.4{\%}) patients developed pancreatitis after ERCP. Patients in the no stent group had 3-fold higher odds of developing pancreatitis compared with the stent group (15.5{\%} vs. 5.8{\%}; OR 3.2: 95{\%} CI[1.6, 6.4]). Number needed to treat analysis showed that one in every 10 patients (95{\%} CI[6,18]) could be expected to benefit from pancreatic-duct stent placement. Conclusions: Prophylactic temporary stent placement across the main pancreatic-duct orifice reduces the risk of post-ERCP acute pancreatitis in patients at risk for developing this complication.",
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N2 - Background: Impaired drainage of the pancreatic duct is one of the possible triggers for post-ERCP acute pancreatitis. The aim of this meta-analysis was to determine whether temporary stent placement across the main pancreatic-duct orifice lowers the frequency of post-ERCP acute pancreatitis in patients at high risk for this complication. Methods: Two reviewers systematically identified prospective studies that (1) compared the risk of post-ERCP acute pancreatitis in patients with pancreatic stent placement vs. no stent placement and (2) included patients at high risk of developing this complication. Studies were assessed for methodologic quality and variations in execution and design. Frequency and severity of post-ERCP acute pancreatitis were the primary outcomes evaluated. Results: Five trials involving 481 patients were selected. Of the 481, 55 (11.4%) patients developed pancreatitis after ERCP. Patients in the no stent group had 3-fold higher odds of developing pancreatitis compared with the stent group (15.5% vs. 5.8%; OR 3.2: 95% CI[1.6, 6.4]). Number needed to treat analysis showed that one in every 10 patients (95% CI[6,18]) could be expected to benefit from pancreatic-duct stent placement. Conclusions: Prophylactic temporary stent placement across the main pancreatic-duct orifice reduces the risk of post-ERCP acute pancreatitis in patients at risk for developing this complication.

AB - Background: Impaired drainage of the pancreatic duct is one of the possible triggers for post-ERCP acute pancreatitis. The aim of this meta-analysis was to determine whether temporary stent placement across the main pancreatic-duct orifice lowers the frequency of post-ERCP acute pancreatitis in patients at high risk for this complication. Methods: Two reviewers systematically identified prospective studies that (1) compared the risk of post-ERCP acute pancreatitis in patients with pancreatic stent placement vs. no stent placement and (2) included patients at high risk of developing this complication. Studies were assessed for methodologic quality and variations in execution and design. Frequency and severity of post-ERCP acute pancreatitis were the primary outcomes evaluated. Results: Five trials involving 481 patients were selected. Of the 481, 55 (11.4%) patients developed pancreatitis after ERCP. Patients in the no stent group had 3-fold higher odds of developing pancreatitis compared with the stent group (15.5% vs. 5.8%; OR 3.2: 95% CI[1.6, 6.4]). Number needed to treat analysis showed that one in every 10 patients (95% CI[6,18]) could be expected to benefit from pancreatic-duct stent placement. Conclusions: Prophylactic temporary stent placement across the main pancreatic-duct orifice reduces the risk of post-ERCP acute pancreatitis in patients at risk for developing this complication.

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