Clinical application of short 5 Fr pancreatic duct stent in difficult biliary cannulation of ERCP / 中国内镜杂志

ABSTRACT

Objective To investigate the clinical applicative of short 5 Fr pancreatic duct (PD) stents in difficult biliary cannulation of ERCP. Methods 131 patients who underwent difficult biliary cannulation during routine ERCP were randomized to receive prophylactic short 5 Fr PD stents (stent group, 66 patients) and not (control group, 65 patients) from January 2012 to October 2015. The success rate of biliary cannulation for the first ERCP, scores of abdominal pain, the incidence of post-ERCP pancreatitis (PEP) and hyperamylasemia and severe post-ERCP pancreatitis were analyzed. Results The success rate of biliary cannulation for the first ERCP was significantly higher with the stent group than the control group. The scores of abdominal pain of the stent group was significantly lower than the control group. The postoperative serum amylase value at 3 h and 24 h were obviously lower in PD stents group than those in control group. The incidence of hyperamylasemia, post-ERCP pancreatitis, severe post-ERCP pancreatitis were also significantly lower with PD stents group than the control group. 3 cm long 5 Fr PD stents has high success rate of placement, high spontaneous migration rate, low complications, decreases the need for endoscopic removal. Conclusion In difficult biliary cannulation during ERCP, placement of short 5 Fr PD stent is safe and effective, enhance the success rate of biliary cannulation, relieve the abdominal pain, reduces the rate of post-ERCP pancreatitis efficiently.