Spontaneous dislodgment of unflanged pancreatic duct stents: A final analysis

E. Fogel, S. Sherman, K. Gottlieb, M. Olssen, G. Lehman

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Needle-knife (NK) precut biliary sphincterotomy (ES) over a pancreatic stent which is left in the duct, or pancreatobiliary ES over a stent, results in significantly lower pancreatitis rates when compared to biliary ES without stent placement. Modification of these pancreatic stents may facilitate spontaneous dislodgment, avoiding a 2nd endoscopy, resulting in lower costs and inconvenience to patients. The aims of this study were to determine (1) the frequency of spontaneous dislodgement of "no intraductal flange" pancreatic duct stents; and (2) the stent characteristics associated with an increased frequency of spontaneous dislodgment. Methods: From 1/95 - 10/97, 429 patients had a 1/2- or 3/4-single pigtail pancreatic duct stent (Wilson-Cook, Winston-Salem, NC) modified with no intraductal flange placed at ERCP. Data were tallied on 360 patients. KUB was obtained 7-14 days (mean 10 days) later to assess spontaneous stent passage. Results: Stent size N Spontaneous dislodgment Yes No 4 Fr 74 50 (68%)*24 (32%) 5 Fr 207 140 (68%)*67 (32%) 6 Fr 52 34 (65%)*18 (35%) 7 Fr 25 18 (72%)*7 (28%) 8.5 Fr 2 1 (50%)*1 (50%) TOTAL 360 243 (68%) 117 (32%) Stent length N Spontaneous dislodgment Yes No ≤ 3 cm 234 187 (80%)@ 47 (20% ≥ 4 cm 126 56 (44%)@ 70 (56%) No inward migration occurred; @P<.001 Summary: 1. Single duodenal pigtail contoured pancreatic stents with no intraductal flange did not migrate into the pancreatic duct. 2. 68% of these "unflanged" stents dislodge spontaneously within 10 days. 3. 80% of short stents (≤ 3 cm) dislodge spontaneously within 10 days. Conclusion: 1. Placement of no intraductal flange stents avoids a 2nd endoscopy in the majority of patients. 2. Further studies are needed to determine the optimal stent characteristics required to protect the pancreas yet pass spontaneously.

Original languageEnglish (US)
Pages (from-to)AB136
JournalGastrointestinal endoscopy
Volume47
Issue number4
StatePublished - Dec 1 1998

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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