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Risk factors for pancreatitis following transpapillary self-expandable metal stent placement

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Abstract

Background

Pancreatitis is one of complications after self-expandable metal stent (SEMS) placement. The purpose of this study was to evaluate risk factors for pancreatitis after endoscopic SEMS placement for malignant biliary obstruction (MBO).

Methods

We retrospectively reviewed 370 consecutive patients who underwent initial transpapillary SEMS placement for biliary decompression. The characteristics of inserted SEMSs were classified according to axial and radial force.

Results

Pancreatitis following SEMS insertion was observed in 22 patients (6%). All of them were mild according to consensus criteria. Univariate analysis indicated that injections of contrast into the pancreatic duct (frequency of pancreatitis, 10.3%), the placement of an SEMS with high axial force (8.3%), and nonpancreatic cancer (16.1%) significantly contributed to the development of pancreatitis, whereas female gender, a younger age, a covered SEMS, and a SEMS with high radial force or without a biliary sphincterotomy did not. In a multivariate risk model, SEMSs with high axial force (odds ratio [OR], 3.69; p = 0.022) and nonpancreatic cancer (OR, 5.52; p < 0.001) were significant risk factors for pancreatitis.

Conclusions

SEMSs with high axial force and an etiology of MBO other than pancreatic cancer were strongly associated with a high incidence of pancreatitis following transpapillary SEMS placement in patients with distal MBO.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan

    Kazumichi Kawakubo, Hiroyuki Isayama, Yousuke Nakai, Naoki Sasahira, Hirofumi Kogure, Takashi Sasaki, Natsuyo Yamamoto, Kenji Hirano, Minoru Tada, Masao Omata & Kazuhiko Koike

  2. Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan

    Osamu Togawa

  3. Department of Gastroenterology, Kanto Central Hospital, Tokyo, Japan

    Saburo Matsubara

  4. Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan

    Takeshi Tsujino

  5. Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan

    Nobuo Toda

  6. Yamanashi Prefectural Hospital Organization, Yamanashi, Japan

    Masao Omata

Authors
  1. Kazumichi Kawakubo
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  2. Hiroyuki Isayama
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  3. Yousuke Nakai
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  4. Osamu Togawa
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  5. Naoki Sasahira
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  6. Hirofumi Kogure
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  7. Takashi Sasaki
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  8. Saburo Matsubara
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  9. Natsuyo Yamamoto
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  10. Kenji Hirano
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  11. Takeshi Tsujino
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  12. Nobuo Toda
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  13. Minoru Tada
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  14. Masao Omata
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  15. Kazuhiko Koike
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Corresponding author

Correspondence to Hiroyuki Isayama.

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Kawakubo, K., Isayama, H., Nakai, Y. et al. Risk factors for pancreatitis following transpapillary self-expandable metal stent placement. Surg Endosc 26, 771–776 (2012). https://doi.org/10.1007/s00464-011-1950-4

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  • DOI: https://doi.org/10.1007/s00464-011-1950-4

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