Analysis of the effectiveness of stenting the duct of the pancreas in patients with impacted stones of the major duodenal papilla

Abstract

Purpose: to evaluate the impact of stenting of the pancreatic duct on the course of biliary pancreatitis for patients with impacted stone of major duodenal papilla. Materials and methods: A retrospective analysis of the treatment of 90 patients with impacted stone of major duodenal papilla that underwent endoscopic interventions on the major duodenal papilla in 1/3 of cases accompanied by the installation of a stent of the pancreatic duct. Depending on the stenting, the patients were divided into two groups - the first group (n = 31 patients) with the stented pancreatic duct, the second group (n = 59 patients) - without stent placement. The groups were compared by the dynamics of changes and the normalization time of laboratory indicators, sonographic signs of biliary and pancreatic hypertension before and after the intervention. Results: Following differences were observed: in the group of stented patients the hyperamylasemia has reduced with the period of normalization of amylase 1.5 times less (p = 0.005) , decrease of amylase at the stented patients with signs of pancreaticectasia at ERCP by 55.6% comparing to the patients without stent - 7.1% (p = 0.005). Laboratory signs of development of post-ERCP pancreatitis were noted in 6.5% of stented and 11.9% of non-stented patients. The average hospitalization time in the first group was 11.5 ± 4.1 days and in the second - 15.5 ± 9.6 days (p = 0.032). Conclusion: Stenting the pancreatic duct in patients with impacted stone of major duodenal papilla reduces the risk of postmanipulation pancreatitis, speeds up the normalization of laboratory markers of acute biliary pancreatitis, reduces the time of hospitalization of this category of patients, has not only a preventive but also therapeutic effect.