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World J Meta-Anal. Jun 30, 2019; 7(6): 259-268
Published online Jun 30, 2019. doi: 10.13105/wjma.v7.i6.259
Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis using pancreatic stents: A review of efficacy, diameter and length
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Takuto Hikichi, Hiromasa Ohira
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Hiromasa Ohira, Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 9601247, Japan
Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Minami Hashimoto, Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 9601295, Japan
Author contributions: Sugimoto M designed and performed the study; Sugimoto M, Takag T, and Ohira H analyzed the data; Sugimoto M, Takag T, and Ohira H wrote the paper; Suzuki R, Konno N, Asama H, Hikichi T, Watanabe K, Nakamura J, Kikuchi H, Takasumi M, Sato Y, Hashimoto M, and Irie H provided clinical advice; and Hikichi T and Ohira H supervised the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tadayuki Takagi, MD, PhD, Assistant Professor, Doctor, Department of Gastroenterology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 9601247, Japan. daccho@fmu.ac.jp
Telephone: +81-24-5471202 Fax: +81-24-5472055
Received: April 15, 2019
Peer-review started: April 15, 2019
First decision: May 8, 2019
Revised: June 2, 2019
Accepted: June 10, 2019
Article in press: June 10, 2019
Published online: June 30, 2019
Processing time: 77 Days and 16.7 Hours
Abstract

Although endoscopic retrograde cholangiopancreatography (ERCP) is an important procedure for the diagnosis and treatment of pancreaticobiliary diseases, post-ERCP pancreatitis (PEP) is the most frequent adverse event that can sometimes be fatal. However, prophylactic pancreatic stent (PS) insertion has been performed to prevent PEP in high-risk patients. In some randomized controlled trials (RCTs) and meta-analyses, the efficacy of prophylactic PS insertion has been shown to prevent PEP. In addition, several types of stents have been used to decrease PEP. In this review, we introduce the details of these RCTs and meta-analyses and reveal the specifications for stent placement, for example, the stent diameter and length and the pancreatic region into which the stent should be inserted.

Keywords: Endoscopic retrograde cholangiopancreatography; Post-endoscopic retrograde cholangiopancreatography pancreatitis; Prophylactic pancreatic stent

Core tip: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is the most frequent adverse event that can sometimes be fatal. Pancreatic stent (PS) insertion is recommended to prevent PEP based on some randomized controlled trials (RCTs) and meta-analyses. Currently, several types of PS have been used. In this review, we introduce these RCTs and meta-analyses and reveal what stent should be used.