PROPHYLACTIC AND CURATIVE PANCREATIC STENTING FOR POST-ERCP ACUTE PANCREATITIS
The aim of the study is evaluation of the effectiveness of pancreatic duct stenting with plastic stents as prevention and treatment of acute pancreatitis after endoscopic retrograde intervention on the papilla of Vater. Materials and methods - from April 2010 to November 2013 were performed 514 ERCP/EST for calculous and malignant obstructive jaundice. Acute pancreatitis developed in 29 (5.6 %) patients, 22 patients had mild pancreatitis, in 6 - average degree and one patient had severe pancreatitis. Pancreatic duct stenting was undertaken in 17 patients, including prophylaxis in 5 patients and as curative measure in 12 patients. Results - stent has been installed in 15 patients and in 2 patients unable to perform cannulation of the pancreatic duct and then the planned stent placement. In case of technically successful stent placement the clinical symptoms of acute pancreatitis and serum amylase and lipase were rapidly regressed. Complications of the pancreatic stenting observed in 2 cases caused by proximal migration of the stent into the lumen of the pancreatic duct (n-1) and occlusion of the lumen of the stent by pancreatic precipitates (n-1). Conclusion - the method of pancreatic stenting with plastic stents is effective measure for prevention and treatment of acute pancreatitis after endoscopic retrograde operations on the major duodenal papilla.