Mo1448 Utility of the Short Single-Balloon Enteroscope (Short-SBE) to Perform Therapeutic ERCP in Patients With Surgically Altered Anatomy

Abstract

Digestive Disease Center, Soonchunhyang University, College of Medicine, Seoul, Republic of Korea Introduction Endoscopic snare papillectomy (ESP) is an efficient treatment for benign tumors of the duodenal major papilla. However, post-ESP pancreatitis is a common and serious complication. Since one prospective randomized controlled trial showed that pancreatic duct stent placement reduced post-ESP pancreatitis, almost physicians have tried to place pancreatic duct stent after EPS. Aims and Methods: The aim of this prospective, randomized trial is to compare the rates of post-ESP pancreatitis in patients who did or did not receive prophylactic pancreatic duct stent placement. Consecutive patients who were to undergo ESP were randomized to pancreatic duct stent placement group (stent group) after endoscopic snare papillectomy or to no pancreatic duct stent placement group (no stent group). Result The groups were similar with regard to patient demographics. In total, 24 patients were enrolled. Fourteen patients were assigned to the stent group and 10 patients to the no stent group. Post-ESP pancreatitis developed in 5 patients (20.8 %, 5/24), 3 cases occurred in the stent group and 2 case occurred in the no stent group. One case of moderate grade pancreatitis developed in the stent group. The overall incidence of post-EPS pancreatitis was 21.4% (3/14) in the stent group and 20.0 % (2/10) in the no stent group (p 0.932). The rates of hyperamylasemia were 14.3% (2/14) in the stent group and 0.0% (0/10) in the no stent group (p 0.493). There was no significant difference in other complications (ex, bleeding and perforation etc.) between the groups. Conclusion: There was no significant difference in the occurrence of post-ESP pancreatitis and hyperamylasemia between patients with and without pancreatic duct stent placement after endoscopic snare papillectomy. Our findings suggest that a pancreatic duct stent placement after ESP did not confer a protective effect in reducing post-ESP pancreatitis. Therefore, more large scaled prospective, randomized controlled studies regarding the effectiveness of pancreatic duct stent placement to reduce the incidence rates of post-ESP pancreatitis are needed.