Pancreatic stents in the treatment of acute biliary pancreatitis

AIM:To evaluate stenting feasibility and outcome in patients with acute biliary pancreatitis.Early endoscopic intervention in acute biliary pancreatitis cannot always relieve the pancreatic duct and theoretically can cause pancreatic injury or obstruction. Pancreatic duct stenting can maintain outflow of the pancreatic juice and improve results in acute biliary pancreatitis.PATIENTS AND METHODS:It was collected retrospective data on 20 patients treated in surgical departments of our hospital during 2013-2015 with acute biliary pancreatitis. ERCP were done in 7 patients (35%) within 24 hours after onset of disease, in 2 patients (10%) within 72 hours and in majority of patients (11 persons, 55%) later than 72 hours. The median age was 61,9±19,4 years. It were mainly mild forms according to Bedside Index of Severity in Acute Pancreatitis: in 90% (18 patients) score was <1, in 2 patients (10%) it was 2.Patients undergone urgent ERCP with endoscopic papillotomy, CBD exploration and pancreatic stenting with 5 Fr stents with variable length without contrast injection.Common bile duct stones were revealed and removed in 10 patients. It were no complications of endoscopic interventions, these patients did not demand any kind of further miniinvasive or surgical treatment of acute pancreatitis.CONCLUSION:ERCP with pancreatic stenting is feasible and improves the outcome of acute biliary pancreatitis. Further data from groups of patients with severe forms are needed for proper evaluation of method effectiveness.