Pancreatic stents for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis should be inserted up to the pancreatic body or tail

Table 1 Comparison of patient demographic and clinical characteristics n (%)

	Head group (n = 131)	Body/tail group (n = 16)	P value
Age, median (range), yr	71.0 (29-97)	66.5 (26-81)	0.052
Male/female	69/62	11/5	0.29
Pancreatic calcification	4 (3.1)1	1 (6.3)	0.45
Parapapillary diverticulum	38 (29.5)2	5 (31.2)	1.0
Diameter of the MPD, median (range), mm	3.1 (0.7-22.0)	3.7 (1.5-13.8)	0.15
Diagnosis
Left hepatic duct extension	1
Biliary stricture
Benign	5
Malignant
Pancreatic cancer	24	7
Biliary tract cancer	33	3
Hepatocellular carcinoma	3
Obstructive jaundice by metastatic cancer
Barrett’s esophageal cancer		1
Colon cancer	4
Gastric cancer	2
Uterine cancer	1
Bladder cancer	1
Ovarian cancer	1
Suppression of lymph node swelling	1
Central bile duct stone	47	4
Primary sclerosing cholangitis	1	1
Gallbladder adenomyosis	3
IPNB	1
Sphincter of Oddi dysfunction	1
Biliary cysts	1
Lemmel syndrome	1

¹ Data from four cases were not available;

² Data from two cases were not available. MPD: Main pancreatic duct.

Table 2 Comparison of endoscopic retrograde cholangiopancreatography procedures n (%)

	Head group (n = 131)	Body/tail group (n = 16)	P value
EST	98 (75.4)	15 (93.8)	0.12
Precut of Vater’s papilla	43 (33.1)	5 (31.3)	1
EPBD	8 (6.2)	0 (0)	0.6
Pancreatic stent migration within 1 wk	26 (19.8)	0 (0)	0.076
Procedure time, median (range), min	60 (20-150)1	60 (40-120)2	0.31
Type of stent
Zimmon 5 Fr, 2 cm	3
Zimmon 5 Fr, 4 cm	1
Geenen 5 Fr, 3 cm	59
Geenen 5 Fr, 5 cm	58
Geenen 5 Fr, 7 cm	11	12
Geenen 5 Fr, 9 cm		4
p-AMY after ERCP, median (range), IU/L	138.5 (7.0-2086)3	78.5 (5.0-1266.5)	0.03
PEP	12 (9.2)	0 (0)	0.363
Mild	2
Moderate	8
Severe	2

¹Data from three cases were not available;

²Data from one case were not available;

³Pancreatic amylase data from seven cases were not available, but the level of serum amylase was not elevated. EPBD: Endoscopic papillary balloon dilation; p-AMY: Pancreatic amylase isoenzyme; PEP: Pancreatitis.

Table 3 Risk factors of post-endoscopic retrograde cholangiopancreatography hyperamylasemia (≥ pancreatic amylase isoenzyme median, 131 IU/L) (univariate analysis) n

	p-AMY < 131 IU/L1 (n = 70)	p-AMY ≥ 131 IU/L1 (n = 70)	P value
Age (≥ 71 yr)	29	41	0.063
Gender (male/female)	40/30	35/35	0.5
Pancreatic calcification	3	2	1
Parapapillary diverticulum	27	16	0.043
MPD ≥ 3.2 mm	36	36	1.0
EST	52	55	0.69
EPBD	3	3	1.0
Precut of Vater’s papilla	18	26	0.20
Stent inserted pancreatic head	58	66	0.06
Pancreatic stent migration within a week	11	12	1.0
Procedure time ≥ 60 min	45	57	0.048

¹Pancreatic amylase data were not available in seven cases, but the level of serum amylase was not elevated. MPD: Main pancreatic duct; EPBD: Endoscopic papillary balloon dilation.

Table 4 Risk factors for post-endoscopic retrograde cholangiopancreatography hyperamylasemia (≥ pancreatic amylase isoenzyme median, 131 IU/L) (multivariate analysis by logistic regression with backward stepwise selection)

	OR	95%CI	P value
Procedure time ≥ 60 min	2.65	1.17-6.02	0.020
Stent insertion into the pancreatic head	3.80	1.12-12.9	0.032