Back to Search
Start Over
Transpapillary stenting of proximal biliary strictures: does biliary sphincterotomy reduce the risk of postprocedure pancreatitis?
- Source :
- Gastrointestinal endoscopy. 45(1)
- Publication Year :
- 1997
-
Abstract
- Background: Pancreatitis after biliary stenting is a rare complication. To reduce this risk, some endoscopists routinely perform biliary sphincterotomy before stenting, but the value of this practice is not established. Methods: The incidence of pancreatitis was reviewed in patients undergoing biliary stenting with and without a biliary sphincterotomy. Results: Postprocedure pancreatitis occurred in 4 of 83 (4.8%) patients treated with transpapillary biliary stents. Patients with proximal biliary strictures were at significantly increased risk for postprocedure pancreatitis (4 of 24) versus those with distal or no strictures (0 of 59) ( p = 0.006). The four patients with pancreatitis after stenting had not undergone sphincterotomy. Of those treated conservatively, two cases were graded severe (one fatal), and one was mild. The other patient was markedly symptomatic from pancreatitis, but improved dramatically after treatment with a needle-knife sphincterotomy done within 24 hours of the original ERCP. Conclusion: The risk of pancreatitis following transpapillary biliary stenting is increased in patients with proximal biliary strictures. Such lesions (malignant or benign) may serve as a fulcrum, leading to medial deflection of the stent and compression of the pancreatic orifice. The hypothesis that sphincterotomy may decrease the risk of biliary stent–induced obstructive pancreatitis should be tested in patients with proximal biliary strictures. (Gastrointest Endosc 1997;45:46-51.)
- Subjects :
- Adult
Male
medicine.medical_specialty
Pancreatic disease
medicine.medical_treatment
Bile Duct Diseases
Biliary Stenting
Sphincterotomy, Endoscopic
Risk Factors
medicine
Humans
Radiology, Nuclear Medicine and imaging
Aged
Cholangiopancreatography, Endoscopic Retrograde
medicine.diagnostic_test
business.industry
Gastroenterology
Stent
medicine.disease
Prognosis
Endoscopy
Surgery
Stenosis
surgical procedures, operative
Pancreatitis
Biliary tract
Female
Stents
Complication
business
Subjects
Details
- ISSN :
- 00165107
- Volume :
- 45
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Gastrointestinal endoscopy
- Accession number :
- edsair.doi.dedup.....e79fb03b120c8317fbae74d79c7574d2