caa a22 4500 445795530 CHVBK 20180317145123.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s10620-011-1695-x doi (NATIONALLICENCE)springer-10.1007/s10620-011-1695-x Prophylactic Pancreatic Stents: Does Size Matter? A Comparison of 4-Fr and 5-Fr Stents in Reference to Post-ERCP Pancreatitis and Migration Rate [Elektronische Daten] [Albert Pahk, Johanne Rigaux, Vijay Poreddy, Joan Smith, Firas Al-Kawas] Background and Aims: The ideal pancreatic stent to prevent post-ERCP pancreatitis (PEP) has yet to be determined. The aim of our study was to assess the relative benefit of 4-Fr versus 5-Fr stents in a population at high risk for post-ERCP pancreatitis, and the relative frequency of spontaneous migration. Patients and Methods: All patients with prophylactic pancreatic stent (PPS) from 2002 to 2009 were reviewed. Patients were classified into two groups according to stent size and compared based on outcome; spontaneous migration or endoscopic removal. Results: A total of 346 PPS were placed in 308 patients (224 women, 84 men). The average age was 48.9years. The most common indication for PPS was sphincter of Oddi dysfunction. Needle knife papillotomy was the most common procedure performed. Forty-seven patients had PEP, 4Fr (14.6%) and 5Fr (12.9%), with only one case of severe pancreatitis. Factors associated with higher rates PEP were younger age and pancreatic sphincterotomy. Complete follow-up was not available in 37 patients. Spontaneous migration was demonstrated in 115 of the 4Fr (95.8%) and 134 of the 5Fr (68.7%). The remaining 66 (five from the 4Fr and 61 from the 5Fr), were removed by endoscopy. The mean delay to demonstrate spontaneous migration was 34.2days. Conclusions: PPS in high-risk patients reduced the risk of post-ERCP pancreatitis and nearly eliminated severe pancreatitis. No significant difference between the 4Fr and 5Fr in reduction of post-ERCP pancreatitis was observed. However, spontaneous migration was more frequent with the 4-Fr stent. Springer Science+Business Media, LLC, 2011 Post-ERCP pancreatitis nationallicence High-risk population nationallicence Pancreatic sphincterotomy nationallicence CT scan : Computed tomography scanner nationallicence EGD : Esophagogastroduodenoscopy nationallicence ERCP : Endoscopic retrograde cholangiopancreatography nationallicence EUS : Endoscopic ultrasonography nationallicence IL : Interleukin nationallicence KUB : Plain abdominal radiography nationallicence PD : Pancreatic duct nationallicence PPS : Prophylactic pancreatic stent nationallicence SOD : Sphincter of Oddi dysfunction nationallicence Pahk Albert Georgetown University Hospital, 3800 Reservoir Road, NW, 20007, Washington, DC, USA aut Rigaux Johanne Hopital Erasme, Route de Lennik 808, 1070, Brussels, Belgium aut Poreddy Vijay Georgetown University Hospital, 3800 Reservoir Road, NW, 20007, Washington, DC, USA aut Smith Joan Georgetown University Hospital, 3800 Reservoir Road, NW, 20007, Washington, DC, USA aut Al-Kawas Firas Georgetown University Hospital, 3800 Reservoir Road, NW, 20007, Washington, DC, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 3058-3064 0163-2116 56:10<3058 2011 56 10620 https://doi.org/10.1007/s10620-011-1695-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1695-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pahk Albert Georgetown University Hospital, 3800 Reservoir Road, NW, 20007, Washington, DC, USA aut NATIONALLICENCE 700 1- Rigaux Johanne Hopital Erasme, Route de Lennik 808, 1070, Brussels, Belgium aut NATIONALLICENCE 700 1- Poreddy Vijay Georgetown University Hospital, 3800 Reservoir Road, NW, 20007, Washington, DC, USA aut NATIONALLICENCE 700 1- Smith Joan Georgetown University Hospital, 3800 Reservoir Road, NW, 20007, Washington, DC, USA aut NATIONALLICENCE 700 1- Al-Kawas Firas Georgetown University Hospital, 3800 Reservoir Road, NW, 20007, Washington, DC, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 3058-3064 0163-2116 56:10<3058 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer