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Table of Contents
Vol. 75, No. 2-3, 2007
Issue release date: August 2007
Section title: Original Paper
Digestion 2007;75:156–163
(DOI:10.1159/000106774)

Pancreatic Duct Stents in the Prophylaxis of Pancreatic Damage after Endoscopic Retrograde Cholangiopancreatography: A Systematic Analysis of Benefits and Associated Risks

Andriulli A. · Forlano R. · Napolitano G. · Conoscitore P. · Caruso N. · Pilotto A. · Di Sebastiano P.L. · Leandro G.
Divisions of aGastroenterology, bGeriatrics, and cAbdominal Surgery, Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, and dDivision of Gastroenterology, De Bellis Hospital, IRCCS, Castellana Grotte, Italy

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 1/15/2007
Accepted: 6/20/2007
Published online: 8/6/2007

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 3

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG

Abstract

Methods: The efficacy of pancreatic stenting in the prevention of pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) was evaluated by a meta-analysis of 6 controlled studies; 12 additional uncontrolled studies were analyzed for rates of associated risk. Results: Post-ERCP pancreatitis (PEP) developed in 16.5% of controls, and in 5.1 or 9.6% of the stent group at the per-protocol (PP) or intention-to-treat (ITT) analyses. By analyzing only the 4 randomized trials, PEP developed in 24.1% of controls, and in 6.1 or 12.0% of the stented patients at the PP or ITT analyses. Risk was significantly lower in the stent group when compared with controls: OR 0.44 (95% CI 0.24–0.81). The absolute risk reduction is 12.0 (95% CI 3.0–21.0), the number needed to treat 8 (95% CI 5–34), and the publication bias 2. ORs for mild to moderate PEP were reduced in the stent group (OR = 0.537, 95% CI 0.283–1.021), as were those for severe PEP (OR = 0.123, 95% CI 0.021–0.726). Non-pancreatic complications were 4.2%, and included early stent migration (1.4%), perforations (0.4%), bleeding (1.4%), and infections (1.0%). Conclusion: Available trials show benefit for pancreatic stenting in the prophylaxis of PEP, but more randomized studies are needed before endorsing a routine use of this endoscopic procedure.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 1/15/2007
Accepted: 6/20/2007
Published online: 8/6/2007

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 3

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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