Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Pancreatic stents to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis: A meta-analysis
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Takuto Hikichi, Hiromasa Ohira
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Hiromasa Ohira, Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima City, Fukushima Prefecture 960-1295, Japan
Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Minami Hashimoto, Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City, Fukushima Prefecture 960-1295, Japan
Author contributions: Sugimoto M designed and performed the study; Sugimoto M, Takagi T and Ohira H analyzed the data; Sugimoto M, Takagi T and Ohira H wrote the paper; Suzuki R, Konno N, Asama H, Hikichi T, Watanabe K, Nakamura J, Kikuchi H, Takasumi M, Sato Y, Hashimoto M and Irie H provided clinical advice; and T.H. and H.O. supervised the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tadayuki Takagi, MD, PhD, Associate Professor, Department of Gastroenterology, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima Prefecture 960-1247, Japan. daccho@fmu.ac.jp
Telephone: +81-24-5471202 Fax: +81-24-5472055
Received: March 4, 2019
Peer-review started: March 4, 2019
First decision: March 27, 2019
Revised: May 7, 2019
Accepted: May 11, 2019
Article in press: May 11, 2019
Published online: May 31, 2019
ARTICLE HIGHLIGHTS
Research background
Endoscopic retrograde cholangiopancreatography (ERCP) occupies an important place in the endoscopic treatment and investigation of pancreatic and biliary diseases. However, post-ERCP pancreatitis (PEP) is a severe adverse effect. To prevent PEP, prophylactic pancreatic stent (PS) placement has been recommended based on the results of several randomized controlled trials (RCTs).
Research motivation
Prior meta-analyses have shown that prophylactic PS was useful for preventing PEP. However, abstract reports and patients who underwent endoscopic ampullectomy were included in the previous analyses. The efficacy of PS for preventing severe PEP was different in each meta-analysis. Therefore, we performed the current meta-analysis, which included only full-text articles, and added new findings.
Research objectives
In this meta-analysis, we evaluated the efficacy of prophylactic PS for the prevention of PEP.
Research methods
We identified the included RCTs by searching MEDLINE, Cochrane Library and PubMed. Among the retrieved reports, 11 studies were included in this meta-analysis. The occurrence of PEP and severe PEP was evaluated.
Research results
The rates of PEP and severe PEP occurrence were significantly lower in patients who received a PS than in patients who did not receive a PS.
Research conclusions
Prophylactic PS was useful not only for preventing PEP but also for preventing severe PEP.
Research perspectives
This meta-analysis proved that prophylactic PS prevented severe PEP. This result will contribute to a reduction in PEP and severe PEP in patients undergoing ERCP.
