Weijie Yao1, Zuozheng Wang1, Yafei Yang2, Zhu Lan2, Jianjun Song1, Dong Jin3, Minghai Shi4, Genwang Wang1, Wenping Bo1, Ming Li1. 1. Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University, Yinchuan, China. 2. Department of Clinical Medicine/Surgery, Ningxia Medical University, Yinchuan, China. 3. Department of General Surgery & Vascular Surgery, Cardiovascular and Cerebrovascular Disease Hospital of Ningxia Medical University General Hospital, Yinchuan, China. 4. Radiology Department, General Hospital of Ningxia Medical University, Yinchuan, China.
Abstract
BACKGROUND: Pancreatic duct (PD) obstruction and hypertension may play a central role in the onset and progression of acute pancreatitis (AP). However, only a few studies have reported using pancreatic stenting to relieve PD obstruction in the early phase of AP, with conflicting results. Whether pancreatic stenting is effective in the early phase of AP remains unknown. We conducted this experiment in order to study the therapeutic efficacy and safety of pancreatic stenting in the early stage of AP. METHODS: We conducted a retrospective analysis of 336 AP patients from 2011 to 2018 who underwent pancreatic stenting within 48 hours of admission. RESULTS: A total of 330 (98.2%) patients underwent successful pancreatic stenting, of whom 23 (7.0%) had severe AP, 178 (53.9%) had moderately severe AP, and 129 (39.1%) had mild AP. Visible PD obstructive material was observed in 94 (28.5%) patients. The mean oral refeeding time since admission and length of hospital stay were 3.5±2.7 and 7.4±6.7 days, respectively. Procedure-related adverse events, in-hospital mortality, and local complication rates were 0.3%, 0.3%, and 7.6%, respectively. CONCLUSIONS: Early endoscopic pancreatic stenting in AP patients effectively shortened the fasting time and length of hospital stay and did not increase the risk of adverse events, death, or local complications. A further prospective randomized controlled clinical trial is currently underway to validate the safety and efficacy of this procedure. 2021 Gland Surgery. All rights reserved.
BACKGROUND: Pancreatic duct (PD) obstruction and hypertension may play a central role in the onset and progression of acute pancreatitis (AP). However, only a few studies have reported using pancreatic stenting to relieve PD obstruction in the early phase of AP, with conflicting results. Whether pancreatic stenting is effective in the early phase of AP remains unknown. We conducted this experiment in order to study the therapeutic efficacy and safety of pancreatic stenting in the early stage of AP. METHODS: We conducted a retrospective analysis of 336 AP patients from 2011 to 2018 who underwent pancreatic stenting within 48 hours of admission. RESULTS: A total of 330 (98.2%) patients underwent successful pancreatic stenting, of whom 23 (7.0%) had severe AP, 178 (53.9%) had moderately severe AP, and 129 (39.1%) had mild AP. Visible PD obstructive material was observed in 94 (28.5%) patients. The mean oral refeeding time since admission and length of hospital stay were 3.5±2.7 and 7.4±6.7 days, respectively. Procedure-related adverse events, in-hospital mortality, and local complication rates were 0.3%, 0.3%, and 7.6%, respectively. CONCLUSIONS: Early endoscopic pancreatic stenting in AP patients effectively shortened the fasting time and length of hospital stay and did not increase the risk of adverse events, death, or local complications. A further prospective randomized controlled clinical trial is currently underway to validate the safety and efficacy of this procedure. 2021 Gland Surgery. All rights reserved.
Authors: Erwin-Jan M van Geenen; Hjalmar C van Santvoort; Marc G H Besselink; Donald L van der Peet; Karel J van Erpecum; Paul Fockens; Chris J J Mulder; Marco J Bruno Journal: Pancreas Date: 2013-07 Impact factor: 3.327
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