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Prevention of post-ERCP pancreatitis using pancreatic duct stenting in difficult cannulation patients with calcular biliary bbstruction


Background: Post-ERCP pancreatitis (PEP) has been the most frequent complication of Endoscopic Retrograde Cholangiopancreatography (ERCP). It has been documented to happen after 5–30% of ERCP procedures. PEP is new or exacerbated abdominal pain associated with a serum lipase or amylase concentration which is more than three times the upper limit of normal at 24 hours post-ERCP, requiring at least two days of prolongation of the planned admission. Following pancreatic sphincterotomy, pancreatic stenting is commonly used with the objective of decreasing both early restenosis and post-ERCP pancreatitis. Aim of the work: Evaluation of the pancreatic stenting technique as a preventive measure against post ERCP pancreatitis in calcular obstructive jaundice patients with difficult cannulation.

Patients and methods: Forty Egyptian patients with calcular biliary obstruction with a difficult biliary cannulation who are at risk of developing PEP enrolled in a prospective randomized controlled comparative study. Group A: 20 patients with manipulation of pancreatic duct by guidewire without pancreatic stent insertion; Group B: 20 patients with manipulation of pancreatic duct by guidewire with pancreatic stent insertion.

Results: The pancreatic duct stenting technique had reduced the risk of PEP significantly in calcular biliary obstruction patients with difficult CBD cannulation to 20?% (in group B) compared with 60?% in (group A).

Conclusion: Prophylactic pancreatic stenting technique is a simple and easy procedure that showed to be efficient in decreasing cases of post ERCP pancreatitis in difficult cannulation patients. The endoscopists should be trained to practice the procedure safely.



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How to Cite

Abdel Rahim, A., Elrefaiy, M. A., Morsy, S. A., El Saadany, M. M., & Mashaal, A. R. (2021). Prevention of post-ERCP pancreatitis using pancreatic duct stenting in difficult cannulation patients with calcular biliary bbstruction. Bali Medical Journal, 10(3), 1061–1066.




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Ali Abdel Rahim
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Mohamed A. Elrefaiy
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Shereif Ahmed Morsy
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Mariam Mosaad El Saadany
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Ahmed R. Mashaal
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