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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 9
Sep.  2025
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Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(9): 1877-1882

Influence of pancreatic stent on pancreatitis after endoscopic retrograde cholangiopancreatography in patients with difficult common bile duct intubation

DOI: 10.12449/JCH250924
  • 1.

    Department of Gastroenterology，The First Affiliated Hospital of Zhengzhou University，Zhengzhou 450001，China

  • 2.

    Department of Gastroenterology，The First Affiliated Hospital of Henan University of Traditional Chinese Medicine，Zhengzhou 450000，China

  • 3.

    Department of Infectious Diseases，Henan Provincial People’s Hospital，Zhengzhou 450003，China

Research funding:

Special Project of Henan Province Traditional Chinese Medicine Scientific Research (2022ZY1030)

More Information
  • Corresponding author: LI Jiansheng， lijianshengzzu@163.com （ORCID： 0009-0002-0302-9223）
  • Received Date: 2025-05-28
  • Accepted Date: 2025-06-17
  • Published Date: 2025-09-25
    Abstract
  •   Objective  To investigate the incidence rate of post-endoscopic retrograde cholangiopancreatography （ERCP） pancreatitis （PEP） in patients with difficult common bile duct intubation undergoing pancreatic duct stenting during surgery， as well as the effect of pancreatic duct stenting in the prevention and treatment of PEP， and to provide a basis for clinical treatment.  Methods  A retrospective analysis was performed for the clinical data of 186 patients with biliary tract disease who underwent initial ERCP and had difficult common bile duct intubation in The First Affiliated Hospital of Zhengzhou University from January 2016 to December 2024， and according to the condition of pancreatic duct stenting， the patients were divided into control group with 73 patients （without pancreatic duct stenting）， 5Fr-5 cm stent group with 67 patients， and 7Fr-5 cm stent group with 46 patients. The three groups were compared in terms of baseline data， intraoperative procedures， and postoperative outcomes. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups； the Kruskal-Wallis H rank sum test was used for comparison of non-normally distributed continuous data between multiple groups， and the Dunn method was used for further comparison between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The Logistic regression analysis was used to investigate the influencing factors for PEP in patients with difficult intubation during ERCP.  Results  The overall incidence rate of PEP was 12.37% （23/186）. Compared with the 5Fr-5 cm stent group and the 7Fr-5 cm stent group， the control group had a significantly higher incidence rate of PEP， a significantly higher score of postoperative abdominal pain， and a significantly longer length of postoperative hospital stay （all P<0.01）， and 55.56% of the patients in the control group had moderate-to-severe PEP. The univariate Logistic regression analysis showed that intradiverticular papilla， double guide wire intubation， needle knife precut， the application of basket and balloon for removal of common bile duct stones， intraoperative biopsy， pancreatic duct stenting， intubation time≤10 minutes， frequency of intubation≤5 times， preoperative CRP≤5 mg/L were influencing factors for PEP （all P<0.05）， and the multivariate Logistic regression analysis showed that intraoperative pancreatic duct stenting， needle knife precut， and intraoperative biopsy were independent influencing factors for the onset of PEP （all P<0.05）.  Conclusion  Pancreatic duct stenting during ERCP can effectively reduce the risk of PEP in patients with difficult intubation， while needle knife precut and intraoperative biopsy can increase the risk of PEP in patients with difficult intubation.

     

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