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CardioVascular and Interventional Radiology

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01-12-2017 | Clinical Investigation

Frequency, Severity, and Risk Factors for Acute Pancreatitis After Percutaneous Transhepatic Biliary Stent Placement Across the Papilla of Vater

Authors: Shunsuke Sugawara, Yasuaki Arai, Miyuki Sone, Hitoshi Katai

Published in: CardioVascular and Interventional Radiology | Issue 12/2017

Abstract

Purpose

To clarify the frequency, severity, and risk factors for acute pancreatitis after percutaneous biliary stent placement across the papilla of Vater for malignant biliary obstruction.

Materials and Methods

This retrospective study included 95 patients who underwent percutaneous biliary metallic stent placement (64 [67.4%] bare stents and 31 [32.6%] covered stents) across the papilla of Vater for malignant biliary obstruction between January 2010 and December 2012. The incidence of acute pancreatitis (Atlanta classification of acute pancreatitis) and its severity (Common Terminology Criteria for Adverse Events, version 4) were reviewed. Additionally, the characteristics of the patients and biliary stents, and the computed tomography findings of the pancreas were evaluated.

Results

Grade 3 acute pancreatitis was observed in 23 patients (24.2%); acute pancreatitis of grade 4 or higher was not observed. The incidence of acute pancreatitis was lower in patients with atrophic pancreas than in those with non-atrophic pancreas (7.5 vs. 36.4%, p = 0.004). It was also lower in patients with main pancreatic duct (MPD) obstruction than in those without MPD obstruction (12.5 vs. 36.2%, p = 0.026). There was no difference in the incidence of acute pancreatitis between bare and covered stents.

Conclusion

Percutaneous biliary stent placement across the papilla of Vater for malignant biliary stricture caused acute pancreatitis requiring medication in 24.2% of patients. Atrophy of the pancreas and the presence of a dilated MPD may be associated with a decreased risk of acute pancreatitis.

Level of Evidence

Level 4, Case Series.

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Title: Frequency, Severity, and Risk Factors for Acute Pancreatitis After Percutaneous Transhepatic Biliary Stent Placement Across the Papilla of Vater
Authors: Shunsuke Sugawara
Yasuaki Arai
Miyuki Sone
Hitoshi Katai
Publication date: 01-12-2017
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 12/2017
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-017-1730-1

At a glance: The STEP trials

Springer Medicine

Frequency, Severity, and Risk Factors for Acute Pancreatitis After Percutaneous Transhepatic Biliary Stent Placement Across the Papilla of Vater

Abstract

Purpose

Materials and Methods

Results

Conclusion

Level of Evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

Level of Evidence

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