Abstract:
BACKGROUND:Placement of a pancreatic duct (PD) stent reduces post-ERCP pancreatitis rates in high-risk patients. Patients with suspected sphincter of Oddi dysfunction (SOD) who are found to have normal manometry results (SOM) are also at high risk for this complication. OBJECTIVE:Our purpose was to determine whether PD stent placement reduces pancreatitis rates in this patient population. DESIGN:Non-randomized, retrospective study. SETTING:Large, tertiary referral center. PATIENTS:From January 1999 to December 2005, patients who underwent ERCP with normal SOM were identified from our ERCP database. Incidence of patient/procedure risk factors for post-ERCP pancreatitis, trainee participation, and prior sphincter therapy were evaluated. INTERVENTIONS:PD stent placement. MAIN OUTCOME MEASUREMENT:Pancreatitis rates. RESULTS:A total of 403 patients were available for analysis: 169 had a PD stent placed (group 1) and 234 did not (group 2). Overall, pancreatitis rates were 2.4% in group 1 and 9.0% in group 2 (P= .006, odds ratio 4.1, 95% CI 1.4-12.0). Other than increased PD opacification in group 1 (P< .001), the incidence of risk factors for pancreatitis, trainee participation, or prior sphincter therapy was similar between the 2 groups. In patients with an intact papilla, stent placement reduced the rate of pancreatitis from 11.5% to 2.7% (P= .012). In patients with prior sphincter therapy, no benefit was seen from stent placement, although there was a trend to decreased pancreatitis rates in stented patients with prior pancreatobiliary sphincterotomy. LIMITATIONS:Nonrandomized, retrospective design. CONCLUSION:Temporary PD stent placement reduces pancreatitis rates in patients with suspected SOD but normal SOM and an intact papilla. Their routine use is recommended when evaluating this difficult, high-risk patient population.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Saad AM,Fogel EL,McHenry L,Watkins JL,Sherman S,Lazzell-Pannell L,Lehman GAdoi
10.1016/j.gie.2007.06.022subject
Has Abstractpub_date
2008-02-01 00:00:00pages
255-61issue
2eissn
0016-5107issn
1097-6779pii
S0016-5107(07)02147-5journal_volume
67pub_type
杂志文章abstract:BACKGROUND AND AIMS:The management of early neoplasia in Barrett's esophagus (BE) requires endoscopic resection of visible lesions, followed by radiofrequency ablation (RFA) of the remaining BE. We evaluated the safety and efficacy of combining endoscopic resection and focal RFA in a single endoscopic session in patien...
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abstract::Percutaneous endoscopic gastrostomy (PEG) provides a non-surgical alternative to long-term enteral feeding. The gastrostomy tube, however, may deteriorate, malfunction, or be accidentally expelled, requiring replacement. A commercial gastrostomy tube is commonly used for replacement. However, a commercial replacement ...
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-03-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
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更新日期:2011-07-01 00:00:00
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doi:10.1016/j.gie.2006.12.038
更新日期:2007-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1067/mge.2002.121336
更新日期:2002-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:1993-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2010-09-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章
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更新日期:1997-05-01 00:00:00
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pub_type: 撤回出版物
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-11-01 00:00:00
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pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.115474
更新日期:2001-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2005-07-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.01.006
更新日期:2014-05-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.07.021
更新日期:2008-01-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.10.035
更新日期:2006-03-01 00:00:00