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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2010
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| 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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| _version_ | 1864513462873358336 |
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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 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| 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 |