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- Title
Risk factors for pancreatitis following transpapillary self-expandable metal stent placement.
- Authors
Kawakubo, Kazumichi; Isayama, Hiroyuki; Nakai, Yousuke; Togawa, Osamu; Sasahira, Naoki; Kogure, Hirofumi; Sasaki, Takashi; Matsubara, Saburo; Yamamoto, Natsuyo; Hirano, Kenji; Tsujino, Takeshi; Toda, Nobuo; Tada, Minoru; Omata, Masao; Koike, Kazuhiko
- Abstract
Background: Pancreatitis is one of complications after self-expandable metal stent (SEMS) placement. The purpose of this study was to evaluate risk factors for pancreatitis after endoscopic SEMS placement for malignant biliary obstruction (MBO). Methods: We retrospectively reviewed 370 consecutive patients who underwent initial transpapillary SEMS placement for biliary decompression. The characteristics of inserted SEMSs were classified according to axial and radial force. Results: Pancreatitis following SEMS insertion was observed in 22 patients (6%). All of them were mild according to consensus criteria. Univariate analysis indicated that injections of contrast into the pancreatic duct (frequency of pancreatitis, 10.3%), the placement of an SEMS with high axial force (8.3%), and nonpancreatic cancer (16.1%) significantly contributed to the development of pancreatitis, whereas female gender, a younger age, a covered SEMS, and a SEMS with high radial force or without a biliary sphincterotomy did not. In a multivariate risk model, SEMSs with high axial force (odds ratio [OR], 3.69; p = 0.022) and nonpancreatic cancer (OR, 5.52; p < 0.001) were significant risk factors for pancreatitis. Conclusions: SEMSs with high axial force and an etiology of MBO other than pancreatic cancer were strongly associated with a high incidence of pancreatitis following transpapillary SEMS placement in patients with distal MBO.
- Subjects
PANCREATITIS; BILIARY tract; CANCER patients; MULTIVARIATE analysis; PANCREATIC duct
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2012, Vol 26, Issue 3, p771
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-011-1950-4