Pancreatic stents to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis: A meta-analysis

Table 1 Patient characteristics of selected studies

Ref.	Country	Sample number		Mean age		Sex (male / female)		Patients
		Stent	No stent	Stent	No stent	Stent	No stent
Smithline et al[55], 1993	United States	43	50	46	47	19/81	22/78	SOD, CBD < 10 mm
Tarnasky et al[51], 1998	United States	41	39	45.7	46.4	NA	NA	SOD
Fazel et al[52], 2003	United States	38	36	45.8	43.6	4/32	6/32	SOD, difficult cannulation
Sofuni et al[19], 2007	Japan	98	103	67.0	66.0	60/38	64/38	NA
Tsuchiya et al[20], 2007	Japan	32	32	65.0	69.0	19/13	22/10	NA
Ito et al[22], 2010	Japan	35	35	68	70	19/16	20/15	Difficult cannulation
Sofuni et al[27], 2011	Japan	213	213	NA	NA	NA	NA	Risk factors, such as SOD, history of pancreatitis
Pan et al[26], 2011	China	20	20	61.0	57.0	9/11	10/10	High-risk patients
Kawaguchi et al[30], 2012	Japan	60	60	66.0	68.0	27/33	25/35	SOD, previous PEP
Lee et al[53], 2012	South Korea	50	51	57.3	57.9	17/33	21/30	Difficult cannulation
Yin et al[45], 2016	China	104	102	57.2	57.4	59/45	55/47	High-risk patients

SOD: Sphincter of Oddi dysfunction; CBD: Central bile duct; NA: Not available; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 2 The factors related to the endoscopic retrograde cholangiopancreatography procedures of selected studies

Ref.	ERCP procedure	Pancreatic stent	Success rate (%)	PEP n (%) stent/ no stent	Criteria of PEP severity
Smithline et al[55], 1993	Precut EST	Double-barbed 5 or 7fr, 2 or 2.5 cm	90	Total 6 (14)/9 (18) Mild 5 (12)/5 (10) Moderate 1 (2)/2 (4) Severe 1 (2)/2 (4)	Cotton
Tarnasky et al[51], 1998	EST	5 or 7Fr, 2 or 2.5 cm	NA	Total 1 (2)/10 (26) Mild 0 (0)/5 (13) Moderate 0 (0)/5 (13) Severe 0 (0)/ 0 (0)	Cotton
Fazel et al[52], 2003	EST	5fr nasopancreatic catheter or Double-barbed 5fr, 2 cm	95	Total 2 (5.3)/10 (28) Mild 2 (5.3)/5 (14) Moderate 0 (0)/2(6) Severe 0 (0)/3 (8)	Cotton
Sofuni et al[19], 2007	EST, EPBD, IDUS, biopsy, sphincter of Oddi manometry, POCS	5Fr, 3 cm with 2 flanges on the duodenal side	97	Total 3 (3)/14 (13.6) Mild 2 (2)/8 (7.8) Moderate 1 (1)/6 (4.6) Severe 0 (0)/0(0)	Cotton
Tsuchiya et al[20], 2007	EST, IDUS, EPBD, sphincter of Oddi manometry	5fr, 3 or 4 cm duodenal pig tail stent without inner flange	100	Total 1 (3.1)/4 (12.5) Mild 1 (3.1)/2 (6.3) Moderate 0 (0)/1 (3.1) Severe 0 (0)/1 (3.1)	Cotton
Ito et al[22], 2010	EST, IDUS, EPBD, biopsy	5fr, 4 cm with a single duodenal pig tail	97	Total 1 (2.9)/8 (23) Mild 1 (2.9)/8 (23) Moderate and severe 0	Cotton
Sofuni et al[27], 2011	EST, EPBD, ENBD, IDUS, biopsy	5Fr, 3 cm with 2 flanges on the duodenal side	88	Total 20 (9.4)/31 (15.2) Mild 16 (7.5)/22 (14.6) Moderate 4 (1.9)/8 (3.8) Severe 0 (0)/1 (0.5)	Cotton
Pan et al[26], 2011	ERCP	5fr single pig tail	NA	Total 4 (20)/14 (70) Mild, moderate, severe NA	Cotton
Kawaguchi et al[30], 2012	Precut EST, pancreatic sphincterotomy, biopsy, IDUS	5fr, 3 cm with two flanges on the duodenal side	100	Total 1 (1.7)/8 (13.3) Mild 1 (1.7)/8 (13.3)	Modified Cotton
Lee et al[53], 2012	EST, precut EST, IDUS, biopsy	Unflanged 3fr, 4, 6, or 8 cm duodenal pig tail stent	96	Total 6 (12)/15 (29.4) Mild 5 (10)/12 (23.5) Moderate 1 (2)/2 (3.9) Severe 0 (0)/1 (2)	Cotton
Yin et al[45], 2016	EST, EPBD	5Fr, 5, 7, or 9 cm	NA	Total 8 (7.7)/18 (17.7) Mild, Moderate, severe NA	NA

PEP: Post-ERCP pancreatitis; EST: Endoscopic sphincterotomy; NA: Not available; EPBD: Endoscopic papillary balloon dilation; IDUS: Intraductal ultrasonography; POCS: Peroral cholangioscopy.