Abstract

Background: Endoscopic snare papillectomy(ESP) is an efficient treatment for benign tumors of the duodenal major papilla. However, acute pancreatitis is the most common and serious complication following an ESP. Aims: The aim was to compare the rate of post-ESP pancreatitis in patients who did or did not receive prophylactic pancreatic stent placement after ESP. Patients & methods: From March 2010 to February 2014, consecutive patients who were to undergo ESP were randomized to pancreatic stent placement group or to no stent placement group. The overall outcomes after ESP including complications were compared between two groups. Results: The 36 patients who received ESP of major duodenal papillary tumors were enrolled. 20 patients were assigned to the stent group and 16 patients to the no stent group. Post-ESP pancreatitis developed in 9 patients (25%, 9/36), 6 cases occurred in the stent group and 3 cases occured in the no stent group. One case in the stent group was considered moderate grade pancreatitis and the others were considered mild grade pancreatitis. The overall incidence of post-EPS pancreatitis were 30% (6/20) in the stent group and 18.8% (3/16) in the no stent group (p1⁄40.700). The rates of hyperamylasemia were 5% (1/20) in the stent group and 6.3% (1/16) in the no stent group (p1⁄40.700). Conclusion: The development of post-ESP pancreatitis and hyperamylasemia were not significantly different in patients with prophylactic pancreatic stent placement compared to those without it. Our data suggest that the effectiveness of prophylactic pancreatic stent placement after ESP may be doubtful. Therefore, more large scaled prospective, randomized controlled studies are needed.

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