Efficacy Of Pancreatic Duct Stents On Prophylaxis Of Post-ERCP Pancreatitis In Patients With Choledocholithiasis With Difficult

Objective To determine whether pancreatic duct stent placement can reduce the prevalen-ce and severity of post-ERCP pancreatitis with difficult cannulation of the bile duct in patients with Choledocholithiasis.Methods 107 patients with difficult cannulation of the bile duct who underwent ERCP from January 2010 to December 2011 were randomly divided into the stent group(n=49) or the no stent group (n=58). The pancreatic duct stent and biliary stent or naso-biliary drainage were placed in the stent group patient, while only biliary stent or naso-biliary drainage was placed in the no stent group patient. The frequency and severity of post-ERCP pancreatitis were observed of the two groups.Results The successful rate of stent placement was 96% (47/49). The incidence of post-ERCP pancreatitis in the stent group was 2.1% (1/47,1 mild), and 19.0%(11/58,9 mild,1 moderate,1 severe) in the no stent group (P=0.015). All patients with post-ERCP pancreatitis were cured after treatment by medication. No complications that associated with pancreatic duct stents were occurred.Conclusions Pancreatic duct stent placement reduces the rate of post-ERCP pancreatitis in patients with difficult cannulation of the bile duct. Stenting of the pancreatic duct should be recommended when dealing with this high risk patient population, who may benefit from this.