Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents

Background: There are conflicting data on the risk of post-ERCP pancreatitis (PEP) related to self-expandable metallic stents (SEMSs). Objective: To compare rates of PEP in patients who undergo biliary drainage with SEMSs or polyethylene stents (PSs). Design: Retrospective, cohort study. Setting: Te...

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Main Author: Azar, Riad R. (author)
Other Authors: Cote, Gregory A. (author), Kumar, Nitin (author), Ansstas, Michael (author), Edmundowicz, Steven A. (author), Jonnalagadda, Sreenivasa (author)
Format: article
Published: 2010
Online Access:http://hdl.handle.net/10725/4111
http://dx.doi.org/10.1016/j.gie.2010.05.023
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.sciencedirect.com/science/article/pii/S0016510710016834
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author Azar, Riad R.
author2 Cote, Gregory A.
Kumar, Nitin
Ansstas, Michael
Edmundowicz, Steven A.
Jonnalagadda, Sreenivasa
author2_role author
author
author
author
author
author_facet Azar, Riad R.
Cote, Gregory A.
Kumar, Nitin
Ansstas, Michael
Edmundowicz, Steven A.
Jonnalagadda, Sreenivasa
author_role author
dc.creator.none.fl_str_mv Azar, Riad R.
Cote, Gregory A.
Kumar, Nitin
Ansstas, Michael
Edmundowicz, Steven A.
Jonnalagadda, Sreenivasa
dc.date.none.fl_str_mv 2010
2016-06-21T05:46:02Z
2016-06-21T05:46:02Z
2016-06-21
dc.identifier.none.fl_str_mv 0016-5107
http://hdl.handle.net/10725/4111
http://dx.doi.org/10.1016/j.gie.2010.05.023
Coté, G. A., Kumar, N., Ansstas, M., Edmundowicz, S. A., Jonnalagadda, S., Mullady, D. K., & Azar, R. R. (2010). Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents. Gastrointestinal endoscopy, 72(4), 748-754.
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.sciencedirect.com/science/article/pii/S0016510710016834
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Gastrointestinal Endoscopy
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description Background: There are conflicting data on the risk of post-ERCP pancreatitis (PEP) related to self-expandable metallic stents (SEMSs). Objective: To compare rates of PEP in patients who undergo biliary drainage with SEMSs or polyethylene stents (PSs). Design: Retrospective, cohort study. Setting: Tertiary-care medical center. Patients: This study involved patients undergoing ERCP for malignant biliary obstruction between January 2005 and October 2008. Intervention: First-time placement of a SEMS or PS for biliary decompression. Main Outcome Measurements: Early post-ERCP complications, particularly PEP. Results: We identified 544 eligible patients, 248 SEMSs (102 covered), and 296 PSs. The etiology of malignant biliary obstruction was similar between groups, with 55% from pancreatic cancer. The frequency of PEP was significantly higher in the SEMS group (7.3%) versus the PS group (1.3%) (OR 5.7 [95% CI, 1.9-17.1]). On univariate analysis, patient age of 40 years, a history of PEP, and at least 1 pancreatic duct injection were also significant predictors of PEP, whereas female sex and having pancreatic cancer were not. When significant variables were added to a multiple-predictor regression model, the odds of PEP from SEMS placement increased to 6.8 (95% CI, 2.2, 21.4). However, the frequency of PEP was similar between covered (6.9%) and uncovered (7.5%) SEMSs (OR 0.9 [CI, 0.3-2.4]). Purported SEMS-specific risk factors, including the use of cSEMSs, overlapping SEMSs, or having a biliary sphincterotomy were not found to be significant contributors to the higher risk. Limitations: Retrospective design. Conclusion: After we controlled for confounding variables, the frequency of PEP was significantly higher with placement of a SEMS compared with a PS. Rates of PEP were comparable with use of covered and uncovered SEMSs.
eu_rights_str_mv openAccess
format article
id LAURepo_01f49aa101d80cdd397d0fc90f7d3218
identifier_str_mv 0016-5107
Coté, G. A., Kumar, N., Ansstas, M., Edmundowicz, S. A., Jonnalagadda, S., Mullady, D. K., & Azar, R. R. (2010). Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents. Gastrointestinal endoscopy, 72(4), 748-754.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
oai_identifier_str oai:laur.lau.edu.lb:10725/4111
publishDate 2010
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repository.name.fl_str_mv
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spelling Risk of post-ERCP pancreatitis with placement of self-expandable metallic stentsAzar, Riad R.Cote, Gregory A.Kumar, NitinAnsstas, MichaelEdmundowicz, Steven A.Jonnalagadda, SreenivasaBackground: There are conflicting data on the risk of post-ERCP pancreatitis (PEP) related to self-expandable metallic stents (SEMSs). Objective: To compare rates of PEP in patients who undergo biliary drainage with SEMSs or polyethylene stents (PSs). Design: Retrospective, cohort study. Setting: Tertiary-care medical center. Patients: This study involved patients undergoing ERCP for malignant biliary obstruction between January 2005 and October 2008. Intervention: First-time placement of a SEMS or PS for biliary decompression. Main Outcome Measurements: Early post-ERCP complications, particularly PEP. Results: We identified 544 eligible patients, 248 SEMSs (102 covered), and 296 PSs. The etiology of malignant biliary obstruction was similar between groups, with 55% from pancreatic cancer. The frequency of PEP was significantly higher in the SEMS group (7.3%) versus the PS group (1.3%) (OR 5.7 [95% CI, 1.9-17.1]). On univariate analysis, patient age of 40 years, a history of PEP, and at least 1 pancreatic duct injection were also significant predictors of PEP, whereas female sex and having pancreatic cancer were not. When significant variables were added to a multiple-predictor regression model, the odds of PEP from SEMS placement increased to 6.8 (95% CI, 2.2, 21.4). However, the frequency of PEP was similar between covered (6.9%) and uncovered (7.5%) SEMSs (OR 0.9 [CI, 0.3-2.4]). Purported SEMS-specific risk factors, including the use of cSEMSs, overlapping SEMSs, or having a biliary sphincterotomy were not found to be significant contributors to the higher risk. Limitations: Retrospective design. Conclusion: After we controlled for confounding variables, the frequency of PEP was significantly higher with placement of a SEMS compared with a PS. Rates of PEP were comparable with use of covered and uncovered SEMSs.PublishedN/A2016-06-21T05:46:02Z2016-06-21T05:46:02Z20102016-06-21Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0016-5107http://hdl.handle.net/10725/4111http://dx.doi.org/10.1016/j.gie.2010.05.023Coté, G. A., Kumar, N., Ansstas, M., Edmundowicz, S. A., Jonnalagadda, S., Mullady, D. K., & Azar, R. R. (2010). Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents. Gastrointestinal endoscopy, 72(4), 748-754.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttp://www.sciencedirect.com/science/article/pii/S0016510710016834enGastrointestinal Endoscopyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/41112021-03-19T10:00:55Z
spellingShingle Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents
Azar, Riad R.
status_str publishedVersion
title Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents
title_full Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents
title_fullStr Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents
title_full_unstemmed Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents
title_short Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents
title_sort Risk of post-ERCP pancreatitis with placement of self-expandable metallic stents
url http://hdl.handle.net/10725/4111
http://dx.doi.org/10.1016/j.gie.2010.05.023
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
http://www.sciencedirect.com/science/article/pii/S0016510710016834