Preventing Post-ERCP Pancreatitis with Pancreatic-Duct Stenting

The most cost-effective strategy is for only high-risk patients to receive prophylactic PD stents.

In several randomized controlled trials and a meta-analysis, researchers showed that pancreatic-duct (PD) stenting significantly lowered the incidence of post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in high-risk patients. Now, investigators have performed a decision analysis to determine which strategy is the most cost-effective for preventing PEP in a hypothetical cohort of 50-year-old people who were undergoing ERCP:

Strategy 1: No patients receive PD stents
Strategy 2: Only patients at high risk for PEP receive PD stents
Strategy 3: All patients receive PD stents

Strategy 1 was the least expensive but yielded the fewest number of life-years. Strategy 2 yielded the greatest number of life-years and, compared w…

Reviewing Author

Stuart Sherman, MD