Impact of pancreatic and biliary stent on post-endoscopic papillectomy complications: A single-center retrospective study

被引:0
作者
Ru, Nan [1 ]
Chai, Ningli [2 ]
Zhang, Bo [2 ]
Li, Longsong [1 ]
Bi, Yawei [2 ]
Linghu, Enqiang [1 ]
机构
[1] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Gastroenterol, Beijing 100853, Peoples R China
[2] Chinese Peoples Liberat Army Gen Hosp, Digest Endoscopy Ctr, Med Ctr 1, Beijing 100853, Peoples R China
基金
中国国家自然科学基金; 中国博士后科学基金;
关键词
Endoscopic papillectomy; Complications; Preventive measures; Pancreatitis; Hemorrhage; SNARE PAPILLECTOMY; AMPULLARY TUMORS; EUROPEAN-SOCIETY; ADVERSE EVENTS; RISK-FACTORS; PLACEMENT; RESECTION; ERCP;
D O I
10.1097/CM9.0000000000002893
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background:Endoscopic papillectomy (EP) is recommended as the first-line therapy for ampullary tumors, despite a relatively high incidence of complications. Pancreatic and/or biliary stents are placed at the endoscopist's discretion to prevent post-EP complications. The present study aimed to evaluate the efficacy of different stents.Methods:A total of 117 patients who underwent EP and met the criteria between June 2006 and October 2022 were enrolled in the study. These patients were divided into a pancreatic stent group (PS group, n = 47), a biliary stent group (BS group, n = 38), and a two-stent group (PBS [PS and BS] group, n = 32). Relevant clinical data were collected and compared among the three groups. Multivariate logistic analyses were performed to explore risk factors for post-EP complications.Results:The incidence of all complications was 37.6% (44/117). Pancreatitis and hemorrhage were the two most common complications with incidence rates of 14.5% (17/117) and 17.9% (21/117). The incidence rates of post-EP pancreatitis were 10.6% (5/47), 23.7% (9/38), and 9.4% (3/32) in the PS group, BS group, and PBS group, respectively, with no significant differences. There were also no significant differences in other complications among the three groups. Age (odds ratio [OR]: 0.95; 95% confidence interval [CI]: 0.91-0.99; P = 0.022) was independently associated with post-EP pancreatitis while tumor size (OR: 1.66; 95% CI: 1.06-2.60; P = 0.028) was independently associated with post-EP hemorrhage.Conclusions:While pancreatic stenting is the first choice to prevent post-EP pancreatitis, biliary stenting could also be considered as a substitute for patients with difficulties in pancreatic cannulation. Two-stent (biliary and pancreatic stent) placement is unnecessary unless it is required due to other concerns.
引用
收藏
页码:2111 / 2118
页数:8
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