Journal
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
Volume 21, Issue 4, Pages 275-280Publisher
WILEY
DOI: 10.1002/jhbp.24
Keywords
Pancreatic duct stent; Post-endoscopic retrograde cholangiopancreatography pancreatitis; Propensity score analysis
Categories
Funding
- Ministry of Education, Culture, Sports, Science, and Technology of Japan
- Research Committee of Intractable Pancreatic Diseases
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BackgroundConducting randomized controlled trial (RCT) for each of the risk factors associated with prophylactic pancreatic duct stent (PPDS) for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is difficult owing to the volume of cases and ethical considerations. In this study, we tried to reveal the degree of preventive effects of PPDS for each individual risk factor within the high-risk group of PEP using the propensity score analysis. MethodsThe clinical data of 1131 ERCP practices performed at Kobe University Hospital from April 2006 to February 2009 were collected prospectively. We investigated their clinical characteristics including the risk factors of PEP, the use of PPDS and complications of ERCP. We conducted the stratification analysis using the propensity score matching analysis. ResultsIn 210 propensity score-matched ERCPs, PPDS proved to be effective in preventing PEP in patients with a history of pancreatitis (odds ratio 0.11, 95% CI 0.01-0.76, P = 0.01) and cases of difficult cannulation (requiring more than 30min) (odds ratio 0.13, 95% CI 0.01-1.14, P = 0.08). ConclusionsPatients with a history of pancreatitis and cases of difficult cannulation are strongly recommended for PPDS placement. The propensity score analysis can be adapted to the ERCP-related analysis with many procedure-related factors with using retrospective data, and may be adapted to investigate the matters that are unsuitable for RCT by volume and ethical issue.
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