Need for pancreatic stenting after sphincterotomy in patients with difficult cannulation

Table 1 Comparison of patient characteristics and diagnoses between the stent and no-stent groups

	Stent group (n = 24)	No-stent group (n = 31)	P-value
Age (mean ± SD)	70.8 ± 12.8	72.4 ± 10.0	0.631
Sex (male/female)	11/13	16/15	0.788
History of pancreatitis	0	0
Periampullary diverticulum	10	13	1.000
Choledocholithiasis	15	21	0.778
Cholangiocarcinoma	4	7	0.739
Acute cholecystitis	3	3	1.000
Lymph node metastasis	2	0	0.186
Gallbladder carcinoma	1	1	1.000
Sphincter of Oddi dysfunction	1	1	1.000
Liver metastasis	0	1	1.000

Table 2 Comparison of endoscopic procedures between the stent and no-stent groups

	Stent group (n = 24)	No-stent group (n = 31)	P-value
Pancreatic guidewire diameter (0.025 inch or 0.035 inch)	12/12	16/15	1.000
Incision range of EST
Small	3	4	1.000
Medium	21	26	1.000
Large	0	1	1.000
Endoscopic biliary stenting	14	11	0.109
Bile duct stone removal	10	19	0.180
Intraductal ultrasonography	7	10	1.000
Endoscopic nasobiliary drainage	3	6	0.716
Biopsy of the bile duct	2	7	0.271
Cytology of the bile juice	3	6	0.716
Endoscopic naso-gallbladder drainage	3	2	0.643
Peroral cholangioscopy	0	3	0.249
Procedure time (min, mean ± SD)	59.3 ± 19.0	66.4 ± 21.6	0.207

EST: Endoscopic sphincterotomy.

Table 3 Comparison of complications between the stent and no-stent groups n (%)

	Stent group (n = 24)	No-stent group (n = 31)	P-value
Overall complications	3 (12.5)	11 (35.5)	0.067
Pancreatitis	1 (4.2)	9 (29.0)	0.031
Bleeding	2 (8.3)	2 (6.5)	1.000
Perforation	0 (0)	0 (0)
Cholangitis	0 (0)	0 (0)

Table 4 Risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis in patients undergoing endoscopic sphincterotomy after biliary cannulation by pancreatic duct guidewire placement

Univariate analysis	Pancreatitis (+) (n = 10)	Pancreatitis (-) (n = 45)	P-value	OR (95%CI)
Age (< 60 yr)	2	9	1.000	1.0 (0.18-5.5)
Female gender	5	23	1.000	0.96 (0.24-3.8)
Periampullary diverticulum	3	20	0.494	0.54 (0.12-2.3)
Pancreatic guidewire (0.035 inch)	4	23	0.729	0.64 (0.16-2.6)
EST incision range (small)	3	4	0.104	4.4 (0.80-24)
No pancreatic duct stenting	9	22	0.031	9.4 (1.1-81)
Endoscopic biliary stenting	3	22	0.318	0.45 (0.10-2.0)
Bile duct stone removal	5	24	1.000	0.88 (0.22-3.5)
Intraductal ultrasonography	4	13	0.479	1.6 (0.40-6.8)
Endoscopic nasobiliary drainage	4	5	0.047	5.3 (1.1-26)
Biopsy of the bile duct	3	6	0.340	2.8 (0.56-14)
Cytology of the bile juice	3	6	0.340	2.8 (0.56-14)
Endoscopic naso-gallbladder drainage	1	4	0.220	3.5 (0.50-24)
Peroral cholangioscopy	1	2	0.459	2.4 (0.20-29)
Procedure time (> 60 min)	5	19	0.733	1.4 (0.35-5.4)

EST: Endoscopic sphincterotomy.

Table 5 Risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis in patients undergoing endoscopic sphincterotomy after biliary cannulation by pancreatic duct guidewire placement

Multivariate analysis	P-value	OR (95%CI)
Incision range of EST ( ≤ small)	0.150	4.7 (0.57-40)
No pancreatic duct stenting	0.045	9.7 (1.1-90)
Endoscopic nasobiliary drainage	0.101	4.6 (0.74-29)

EST: Endoscopic sphincterotomy.