Letter in Response to the Recently Published Study: Prophylactic Pancreatic Stents: Does Size Matter? A Comparison of 4-Fr and 5-Fr Stents in Reference to Post-ERCP Pancreatitis and Migration Rate

Excerpt

We read with great interest the study published by Al-Kawas et al. [1] regarding migration rates of 5-Fr and 4-Fr pancreatic duct stents. However, we disagree with the main conclusions of the study, namely the migration rates and post-ERCP pancreatitis rates. It is known that pancreatic stents with intraductal flanges and those of longer length have a lower spontaneous migration rate. In their study, the authors failed to provide the readers with pertinent information about the number of 5-Fr stents with intraductal flanges and stent length. In patients who received 5-Fr stents, there was a wide range of lengths from 2 to 11 cm, though the number of each length is not mentioned. These stent-related factors impact the spontaneous dislodgement rates; the authors pooled the data from these vastly different stent lengths into one group and concluded that the spontaneous dislodgement rate was significantly lower than that compared to a group who received 4-Fr pancreatic stents without an intraductal flange and of undisclosed, presumably uniform lengths. …